Russell Fraser will be remembered as the pioneer of scientific endocrinology in the UK, the Commonwealth and beyond. His influence is still felt and many endocrine departments throughout the world share working practices which had their origins in the ‘medical corridor’ at Hammersmith.
He was born in Wellington, New Zealand, the son of Malcolm Fraser, a government statistician, and Caroline (née Watson), an accomplished pianist. Educated at Scots College, Wellington, he was senior scholar in the New Zealand University entrance examination and received medical training at the Otago Medical School, Dunedin. While still a student he toured extensively in the North and South Islands, gaining a reputation as a competent climber and mountain guide.
In 1932 he graduated top of his class with distinction, gaining all live gold medals for the year. After a period as senior demonstrator at the Otago Medical School and house jobs at Greymouth and Wellington, he left New Zealand as medical travelling scholar to work in London. On arrival there he topped the primary examination of the Royal College of Surgeons and was awarded the Hallett prize for 1935. As New Zealand fellow in biochemistry he worked at the Middlesex Hospital and then as house physician at the Hammersmith and Maudsley Hospitals. At the Maudsley he published papers with William Sargant [Munk’s Roll, Vol.VIII, p.434] on hyperventilation insulin shock therapy and schizophrenia. It was here that he met nurse Maud Besley, his future wife, when in predictable fashion he rescued from her psychiatric ward a patient whose psychosis later responded to endocrine surgery. They married in 1946.
In 1938 he was awarded a Rockefeller travelling fellowship and joined Fuller Albright, the doyen of American endocrinology, at the Massachusetts General Hospital in Boston. Working in a metabolic ward he conducted studies on 17-ketosteroids and glucose tolerance and, as Albright later acknowledged, was the first to identify the syndrome of ovarian dysgenesis and short stature. His experience there, and particularly the ongoing studies of calcium metabolism, laid the foundation for what was to become a lifelong interest.
He returned to the UK in 1940 and, during the Second World War, was directed away from general medicine to an appointment as psychiatrist at the Mill Hill Emergency Hospital. Later he spent four years as psychiatric investigator for the Ministry of Home Security and the Medical Research Council. During these appointments he studied the effects of bombing and the incidence of neuroses in industrial workers.
From 1946 onwards he was back on course, appointed successively medical registrar, lecturer, reader in medicine and honorary consultant at the Royal Postgraduate Medical School and Hammersmith Hospital. This was an exciting period in the department of medicine. Under the firm leadership of Sir John McMichael [Munk’s Roll, Vol.IX, p.341] specialty departments were developed with priorities in research and teaching. The Postgraduate School was an entrée into British medicine, attracting postgraduate students from the UK, the Commonwealth and beyond. Given charge of the endocrine laboratories, Russell Fraser retained responsibility for general medicine, but also developed a comprehensive endocrine service and a broad-based endocrine research programme. In 1957 he was appointed to the chair of clinical endocrinology, a post which he held until his retirement.
A likeable man, unassuming and relatively informal, he fitted into this cosmopolitan environment. His sharp intellect, his innovative approach to research problems and his ability to advise, encourage and direct, quickly attracted followers. He had a soft spot for Australasians, but the department was home to UK graduates, Canadians, Americans, Greeks, Finns, Indians and others, many of whom came to occupy senior academic posts in their own countries. A prodigious worker, often in his book-filled study until the early hours, he would appear at the hospital next morning seemingly fresh with sheets of data filled pages for discussion; a tendency to nod-off in the post prandial afternoon X-ray sessions giving the only hint of his nocturnal activity. Affectionately known as ‘Rusty’, he was a father figure and greatly respected by his junior colleagues. Tenacious and sometimes downright stubborn in his pursuit of the truth, he could also be persuaded by logical argument. His wide ranging interests were reflected in the scope of his research programmes which touched on every endocrine gland known at the time. Hormone measurement was in its infancy and alternatives were needed. He exploited the recently discovered radio-iodine for the investigation of thyroid disorders. His mathematical propensity led to the development of a complex ‘T Index’ based on measurement of 131I in timed urine samples. His patients could be easily identified on the London streets carrying the oblong wicker baskets with their three Winchester collection bottles. The Albright tradition was maintained in 1954 when a new metabolic unit was opened by Her Majesty the Queen. This facility allowed for a new level of precision in detailed studies of calcium disorders and other metabolic diseases. Sample collection was the order of the day and not a drop must be spilt!
He was a fearless investigator. Though not known for his manual dexterity, he developed several ‘hands-on techniques which he exploited to the full. The high pitched whine of the compressed air-driven thyroid biopsy drill was almost as alarming to his junior staff as it was to the patients. The implantation of radioactive ‘seeds’ of yttrium or gold into the pituitary gland through a hole drilled through the skull base was a less invasive alternative than conventional neurosurgery for patients with acromegaly, Cushing’s disease and other pituitary based diseases. Useful improvement was obtained from pituitary ablation in breast carcinoma and diabetic retinopathy, but this has since been superseded.
He was a physician, not a surgeon, but easily assumed this mantle, performing the operation in the operating theatre suitably gowned and looking like the real thing. On one occasion the precious seed went missing, to be found much later in his upturned trouser cuff. He carried on quite unperturbed, a quality demonstrated in many other crisis situations.
A particular characteristic was his complete dedication and total involvement in everything he did. His innovative flare was apparent in the family home, with beehives on the roof, heated wires in the vegetable garden to beat the London frost, and in the kitchen a winery of Winchester bottles and plastic tubing to regulate the flow. The three children, Ian and the adopted twins Caroline and Charles, were given free reign, while Maud Fraser applied appropriate controls with grace and good humour. Ian Fraser later opted for surgery, somewhat to the surprise of his father who had failed to recognize a rebel in the camp.
There were many departmental ‘occasions’ when the house was opened to members of the team gathered from all corners of the globe. Sailing was a passion which occupied the whole family whenever possible. A converted railway carriage near Lymington was the base from which many of us experienced the exciting and sometimes alarming vagaries of maritime life on the Solent.
Russell Fraser regarded clinical research as an essential component of his daily life. A busy medical academic with major teaching and administrative responsibilities, he was able at the same time to direct and co-ordinate the diverse interests of his many research fellows with seemingly little effort. He published more than 300 high grade scientific papers and chapters on topics relating to almost every known endocrine gland.
From 1965 he was co-director of the endocrine unit with Iain MacIntyre and between 1971 and 1973 chairman of the academic board at the Royal Postgraduate Medical School. He was a member of many scientific societies and involved in the editorial work of the Journal of the Association of Physicians UK, Diabetologia, Hormone and Metabolic Research and Proceedings of the Royal Society of Medicine. He later chaired the MRC working party on clinical trials of growth hormone and was chairman of the pituitary sub-committee of the RSM.
There were many overseas trips with visiting professorships in clinical endocrinology at the Otago Medical School, Dunedin, Emory University, Atlanta, and the Postgraduate Medical School, Chandigarh.
In 1975 he spent a year in Auckland as visiting professor in the department of medicine and returned to New Zealand again in 1976 as deputy director of the Medical Research Council (NZ). In this post he was largely responsible for the organization of the National Hormone Committee and Hormone Extraction Laboratory, which was to supply growth hormone and gonadatrophin for therapeutic use. He continued his research on calcium metabolism, publishing papers on Paget’s disease and its treatment with the newly available bisphosphonates.
In his later years he developed symptoms of Parkinson’s disease, but continued to contribute to departmental activities until shortly before his death.
H K Ibbertson