William Wallace Brigden was a consultant cardiologist at the London Hospital, at the forefront of the specialty during a period of unprecedented development and expansion. He was a brilliant student and a series of scholarships funded his education. From Latymer school he went to King’s College, Cambridge, where he obtained a double first. In 1937 he went to Yale, which sent him to Alaska to study arctic sea birds. A year later, in 1938, he entered King’s College Hospital, London, where Terrence East [Munk’s Roll, Vol.VI, p.157] kindled his interest in cardiology. He qualified in 1941 and obtained his membership of the College in the same year.
He joined the RAMC as a specialist physician in 1944 and served at first in Naples and then moved via Caserta to Milan, where he witnessed the grim sight of Mussolini and his mistress hanging after their execution in April 1945. He served a further two years in India at the time of partition and was demobilised in 1947. War service marked his generation, though they rarely spoke of it. They returned with a determination to improve the lot of their fellow men and to make a success of the new NHS.
Wallace joined the Hammersmith Hospital as a lecturer and physician in 1947 and was appointed physician with an interest in cardiology at the London Hospital in 1949. His appointment to the staff at the London Hospital at the early age of 33 was a bold move. Under Sir James Mackenzie [Munk’s Roll, Vol.IV, p.533], Sir John Parkinson [Munk’s Roll, Vol.VII, p.443] and William Evans [Munk’s Roll, Vol.VIII, p.146], cardiology had become one of the most prestigious departments. Appointments usually went to older doctors with a proven track record and from within the hospital.
Cardiology had been largely based on the correlation of the patient’s history, the physical signs and post mortem findings. It was concerned with the diagnosis and observation of heart disease since, apart from superb nursing, digitalis and mercurial diuretics given intravenously, there was little for the cardiologist to offer therapeutically. In his early days, the main function of a teaching hospital cardiologist was to teach medical students and he excelled. He brought a new style. Teaching had tended to be didactic and authoritarian, almost by rote, but he was friendly, relaxed and informative. He encouraged students to ask questions and to think for themselves. The teaching hospitals took great pride in themselves and he was fiercely loyal to the London Hospital and his junior staff. He was a ‘London Hospital man’.
He entered cardiology at the dawn of a golden age, as it was becoming the most exciting specialty in medicine. Cardiac catheterisation and advances in physics and electronics, spurred by the Second World War, improved imaging and allowed blood pressures and oxygen saturations within the heart to be measured in the living patient. Wallace and others linked these laboratory findings with precise bedside observations. Taking a history and using his eyes, hands and stethoscope with such simple aids as a chest X-ray and electrocardiogram, he would make a complete bedside diagnosis. To the students it seemed almost magical. Diagnosis was no longer the end of the story. As time went on patients could be offered powerful medications, surgery and other interventions.
Wallace was at the forefront of the advances in cardiology. He established mitral regurgitation as an entity and not part of mitral stenosis, and he and Aubrey Leatham followed cases for 30 years and more. He wrote papers on the simpler congenital heart diseases and was a world authority on the heart muscle disorders of pregnancy and the puerperium and those due to alcohol. He served as assistant editor of the British Heart Journal and was consultant cardiologist to the Royal Navy. He was chief medical officer at Munich Re and was one of the presidents of the Assurance Medical Society.
One day in his early sixties when he was to take a teaching round at the London Hospital his glasses fell to the floor and shattered. He was taken to the eye department for spectacles to get him through the afternoon. While he was waiting Mr Ayoub, the ophthalmic surgeon, examined the eyes. “How long have you had glaucoma?” he asked. Wallace had not known. He should have been able to continue in private work, life insurance underwriting and teaching for another 10-15 years, but he had to gradually give up because of failing sight. His wife Everel looked after him devotedly in the last years that were marred by blindness and a series of small strokes, but his recollection of the early days remained as clear and vivid as ever.
He is survived by his wife Everel, two sons (one a cardiologist) and a daughter from his first marriage and a son and stepson from his second. He is remembered with gratitude and affection by his patients and all the doctors he taught, encouraged and inspired.
Malcolm Towers