The foundation of the Clinical Medical School at the University of Cambridge, after years of discussion and against seemingly insurmountable opposition, owed much to the vision and quiet determination of Theodore Chalmers. This was one of many achievements in a distinguished medical career.
Chalmers was born in Inverness, the youngest of three sons of a Highland family with a strong medical tradition. He was educated at Inverness Royal Academy and received his medical training in Edinburgh, where he graduated in 1941. After an appointment as house physician in Inverness, he served in the Royal Air Force for five years, performing unit and hospital duties as a squadron leader in the combat zones of North Africa and Italy. He spoke little of his war experiences in later life but they no doubt contributed to his passionate opposition to nuclear weapons and his disinterest in chauvinism. He seriously considered settling in Italy, but on return to England he decided to resume his career in civilian life, first at the Brompton Hospital and then as registrar at the Hammersmith Hospital. His research interests began at the Middlesex Hospital where he studied the effects of autonomic drugs on sweat secretion, which formed the basis of his MD thesis. This took him to the fields of electrolyte and water metabolism and neurohypophyseal function, which led him to describe the use of nicotine as a diagnostic test in diabetes insipidus [Clin. Sci. 1951,10,137-144]. At that time considerable advances were being made into the effects of adrenal corticosteroids on electrolyte metabolism, and he pursued this line of research whilst a Nuffield Foundation fellow at the University of Pennsylvania Hospital in Philadelphia. On his return to this country he became senior lecturer in medicine at the Welsh National School of Medicine in Cardiff and during his short stay there he described one of the earliest cases of Conn’s syndrome [Lancet, 1956,1,127-132]. He then returned to London as first assistant to the professorial medical unit at the Middlesex Hospital in 1954. There he made studies of adipose tissue metabolism and obesity, and in particular of the fat mobilising activity of fasting urine, a subject in which he later collaborated with the University department of biochemistry at Cambridge [Lancet, 1958,1,866-869]. His research into adipose tissue metabolism formed the basis of the Malthe lecture to the Norwegian Medical Association which he delivered in 1964.
Chalmers moved to Cambridge in 1962 on his appointment as consultant physician to the then United Cambridge Hospitals and East Anglian Regional Hospital Board. His main duties were at Addenbrooke’s Hospital but he also had clinical responsibilities at Fulbourn Hospital and the County Hospital at Huntingdon. From the start he set up a first class clinical service and organized postgraduate clinical teaching sessions which he maintained throughout his career. He retained his broad interest in endocrinology but now turned his attention to bone and mineral metabolism. These new interests were relatively untapped areas of research in Cambridge and over the next 20 years he and his co-workers published a series of papers on hyperparathyroidism, renal stones, metabolic bone disease and vitamin D metabolism. All this coincided with major advances in the understanding of vitamin D metabolism by a group of scientists directed by Egon Kodicek at the MRC Dunn Nutritional Laboratory in Cambridge, which culminated in their discovery of the unique steroid hormone 1,25-dihydroxycholecalciferol. Chalmers fostered links with this group and their friendly collaboration produced nearly 20 years of fruitful research.
In 1965 he was elected Fellow and director of medical studies at St John’s College, Cambridge, where he taught physiology and guided the careers of countless medical students. Although not schooled in Cambridge he was proud of his association with St John’s and had a high regard for its tradition, style and excellence. He was appointed dean of the School of Clinical Research and Postgraduate Teaching at Cambridge in the same year. It was natural, with his long academic background and deep interest in medical education, that he should take on this role and he quickly recognized the potential for extending medical education and clinical research in Cambridge, and that these goals could best be realized with the establishment there of an undergraduate clinical medical school. He espoused this cause despite the widely known and long held opposition to such a proposal from many within the University. This did not deter him and, with the favourable attitudes expressed in the Todd report of 1968 and the redevelopment of Addenbrooke’s on the ‘new site’, the time was ripe for such a venture. He was appointed to the Clinical School planning committee in 1969 and in that role travelled widely in the USA studying medical curricula. After prolonged and sometimes difficult negotiations, which he conducted with customary patience and determination, the clinical school was established in 1975 and Chalmers became the foundation dean. He held this post for four years before returning to full-time clinical practice in 1979. During that time a novel curriculum was introduced, incorporating in-depth topic teaching and extending the Cambridge preclinical supervision system into the clinical years.
Chalmers was a member of the Association of Physicians and served at various times on the executive committees of the Medical Research Society and Renal Association; as honorary secretary of the Middlesex Hospital Research Society, and of the section of experimental medicine and therapeutics of the Royal Society of Medicine. He was a member of the Council of the Royal College of Physicians, and won election to the General Medical Council in 1979 which enabled him to continue his interest in general medical education. He was held in high regard as an examiner in the final MB and periodically served in this capacity for the universities of Cambridge, Belfast, Wales, London, St Andrews and Manchester. He was also external examiner for the first final MB examination to be held at the medical school at Enugu, Nigeria. He established a lasting association with this institution, so that many students from Nigeria were enabled to take their electives in Cambridge.
As a physician, Chalmers was a man of the highest intelligence and integrity. His junior medical and nursing colleagues developed a strong sense of loyalty to him and the things he stood for, and strove hard to match his high standards. He brought the best out of people and was particularly good with medical students. An excellent and decisive clinician, with a wide knowledge of medicine, he consistently took superb clinical notes and was an avid reader of journals. His modest, calm and phlegmatic manner was an example to us all. An honest and straightforward man with a light, dry sense of humour, he was never harsh or unduly critical but he despised dogma, arrogance and incompetence. He practised transcendental meditation to an advanced level and was particularly interested in physiological responses to this technique, and its application to the treatment of anxiety and mild hypertension. As a founder member of the British Association for Medical Applications of Transcendental Meditation he did much to promote interest in the subject both within and outside the medical profession.
At a personal level, Theo was a quiet and unassuming family man. His interests were highly intellectual. He was especially fond of music and, with his wife, sang in the Cambridge Philharmonic Choir, often giving snippets of rehearsals to his juniors in the lifts between ward rounds. He also enjoyed gardening and camping holidays in France with his family.
He married Doreen Boorman in 1951, by whom he had three daughters and two sons, one of whom also qualified in medicine.
[Brit.med.J., 1984,289,506,773; Lancet, 1984,2,474,533,994; Times, 14 Aug 1984]