British Journal of Neurosurgery, June 2014; 28(3): 300–301 © 2014 The Neurosurgical Foundation ISSN: 0268-8697 print / ISSN 1360-046X online DOI: 10.3109/02688697.2014.928774
OBITUARY His neurosurgical training started under Mr. Johnson and Mr. Dutton in Manchester, where he was highly influenced by the very positive and active operative teaching, especially with Mr. Johnson, who during a period of considerable absence from the unit asked John to look after his private patients – a tribute indeed to any senior trainee. He then moved to the Radcliffe Infirmary, Oxford to complete his training with Mr. Pennybacker and Mr. Potter. The founding neurosurgeon of the Neurosurgical Unit at the Brook Hospital in Woolwich, Mr. Geoffrey Knight was retiring. His main interest was the treatment of affective disorders, especially depressive illness with a modified frontal leucotomy technique, performing a subcaudate tractotomy using stereotactically placed Yttrium-99 seeds. John had a wide range of surgical skill particularly the removal of difficult tumours including acoustic neuromas. The flavor of the post on offer was not entirely to his liking, but Mr. Pennybacker encouraged him to “go for it”, confident that John would, with his excellent surgical skills soon do the sort of neurosurgery he really wanted to pursue! So in January 1971 he moved to Blackheath, near “The Brook”, to start work alongside Mr. George Northcroft and Mr. John Gibbs. As a new consultant he engaged in most aspects of the specialty but also was a forerunner of sub-specialization and in particular refined his surgery for tumours, bringing into play the CUSA, LASER and microsurgery during their early introduction to neurosurgical practice, having been one of the first neurosurgeons from the UK to go to study microsurgery with Professor Yasargil in Zurich. He continued a heavy commitment to psychosurgery alongside Dr. Paul Bridges, the consultant psychiatrist, co-authoring numerous publications. The field aroused much controversy, but despite sometimes extremely aggressive hostility from those determined to see this work stopped, they stayed supportive and remained strong advocates for the patients, all refractory to every other method of treatment and desperate. They knew this type of treatment was an absolutely “last resort” and but it helped many to be freed from institutional care. Enabling this “lesion” producing type of treatment to continue has acted as a crucial springboard for today’s renewed interest in less controversial deep brain stimulation techniques. The quirks of the aging Victorian Brook Hospital, gave him opportunity to employ his photographic skills with colleagues too, receiving the Bronze award in the 1988 Blithe and BMA Film and Video Competition, for ‘Psychosurgery: A Last Resort’, a stimulus for the BBC2 QED programme broadcast in March 1990. He became an Associate of the Royal Photographic Society in 1993 when he presented a panel of pictures depicting daily life in the Brook. “JRB” trained numerous doctors. As a newcomer one was immediately fired by his enthusiasm, energy, and pride in the unit, and everyone he worked with. His great intellect was instantly evident, as also the fondness and respect shown to him by staff of every level. He wasn’t a lover of formality and
John Bartlett: A tribute to a distinguished and much loved neurosurgeon who worked through a period of extraordinary change
Fig. 1. John Bartlett.
18th January 1934 – 6th January 2014
Consultant Neurosurgeon (1971–1998); President of the Society of British Neurological Surgeons (1996–1998) John Richard Bartlett (Fig. 1) was born in Saffron Walden in 1934. Aged ten he was given a book “The Boy Electrician”. The subject crystalized a lifelong passion for science. His grandmother searched out the plates and box cameras taken to Africa by his grandfather Sir John Kirk during explorations with Livingstone in the 1860s, starting a lifelong interest in photography. In 1947 he went to Radley College where he was introduced to rowing, his main sport during school and college years. Uncertain of what to do after school he considered engineering, but as his grandfather, both parents, and an aunt were doctors and an uncle, Sir Almroth Wright, engaged in medical research, he was led inexorably to medicine, reading Natural Sciences at Peterhouse College, Cambridge and Medicine at St Mary’s Hospital Medical School, qualifying in 1958 and then appointed House Surgeon to Sir Arthur Porritt. A junior post at the Midland Centre for Neurosurgery, working for Dr. Bickerstaff and Mr. Small, and a nine month spell in The Birmingham Accident Hospital with Prof. Gissane and Mr. London convinced him that he wanted to become a Neurosurgeon, obtaining his FRCS in 1966. 300
Obituary you became a true apprentice, learning by “osmosis” and encouragement to do your best. His inspirational teaching was instrumental in many becoming distinguished physicians and surgeons. He made a point of his trainees becoming excellent future “ambassadors” of the unit. As a clinician he was excellent, in the style of a good neurologist, taking a careful and probing “history”, really listening to the patient, and examining them sensitively and carefully – looking for little clues, however small. Policies and protocols were not for him! “Why go to medical school unless it’s to learn to understand the natural history and pathology of disease and above all think!” But of course managing complex conditions involves far more than this. “You can make a diagnosis, but what are you going to do about it?” He would often say. With his absolute passion for science in its broadest sense and his supreme logic he would work out from “basic principles” the best way to solve the task at hand (a message he would frequently convey to his own children helping them with homework!), all done under a beguiling veil of calm kindness, and empathy. He would weigh up with precision the optimum treatment for each individual, fully taking into account the real and often forgotten limitations of modern neurosurgery at its best, and also the limitations that might exist for the patient. His love of learning and generous teaching style were deeply intertwined with a visionary fascination for modern technology. As computers became available John spent many happy hours with his four children, trainees and colleagues, leaning to manage systems and develop programs. These skills were used to good effect in driving forward the computerization of the Neurosurgical Unit clinical records system well in advance of other centers, and presenting this work to the Society of British Neurological Surgeons (SBNS). He was involved in several major publications on the use of CT scanning in its infancy, the Brook Unit having one of the very first CT scanners in the World. Various other allied publications on the economic evaluation and implications of new diagnostic equipment were also undertaken, including a paper in the British Medical Journal with, amongst its authors, Sir John Banham, who become Director General of the Confederation of British industry. Later he pioneered hard to get access to MRI, immediately seeing its huge potential and the revolution it would cause in spinal imaging and diagnosis. Glenn Neil-Dwyer, Michael Sharr and Richard Gullan, his most long standing neurosurgical “working colleagues” agree that in the operating environment John was supreme. His ability to handle the brain with the gentlest of touch, whilst moving the operation forwards with a perfect pace of dissection was legendary. The results spoke for themselves. His close anaesthetic colleagues David Hurter and Lorice Songhurst loved working for him because there were no “unexpected moments of excitement”, so much loved by filmmakers but hated by truly professional surgeons. As he would say “if things seem exciting it always strikes me that perhaps something has gone wrong”. As a trainee one would be so easily tricked into thinking this was easy, just as we all are when we watch any world-class musician or sportsman at work!
301
His earlier career was blighted by political indecision and uncertainty over the future of the Brook Unit. Varieties of options were considered, often in much time-consuming detail, and resulting in confrontation between various parties involved. Almost 30 years after the initial Ministry of Health meeting in 1967 to rationalize neurosurgical provision for the Metropolitan Regions the Brook Unit was amalgamated with the Guy’s/Maudsley Unit within King’s College Hospital in 1995 to form a single Neuroscience Centre for SE London, East Sussex and Kent. However in management he held the total respect of his peers. As a result he chaired any committee with quiet but determined authority, tempered with the occasional timely and strategic political salvo to someone in “high places”, akin to a sniper’s bullet! These skills were a great asset during his Presidency of the Society of British Neurological Surgeons at a time when there was much need for change. He was highly instrumental in revising the Society’s constitution and structure to make it fit for purpose in a rapidly modernizing speciality within the Health Service. Once established in King’s, as the senior consultant neurosurgeon he showed great leadership and was determined to make the unit flourish, despite all the past conflict and bitter last minute decision to cancel the construction of a new purpose built unit that had been fully designed and should have opened on the Maudsley site in 1995. He rapidly engaged with new colleagues to help create two of the busiest services for pituitary and acoustic neuroma surgery in the UK. His lifetime dedication to the concept of keeping neurosurgery safe was amply shown by his determination to encourage good team working and the preparation of important SBNS documents within the framework of the Royal College of Surgeons, resulting in his much deserved election as President of the SBNS at the close of his clinical career. In retirement photography became his main hobby and many people will remember him with his camera around his neck and seeing exhibitions of his work, often carried out on holidays in “remote” places. He was President of the Bromley Camera Club for its centenary year and London Organizer for the Royal Photographic Society. He always had time for anyone who was starting out on their photographic adventure and would give what help he could, teaching all four of his children use of the camera, the darkroom, the principles of light and composition, and being rewarded by three of them taking up professional careers in photography and film. This very special man and true “doctor” displayed a passion for the welfare and care of his patients, leaving a great legacy behind him. He was a perfect model for neurosurgical determination and vision, tempered by great modesty, grace and humility. His sad loss from unrelenting prostate cancer can never be filled; supported throughout by his devoted wife Cilla, a pillar of strength to him at every corner of his glowing career, and his deeply loved four children and grandchildren. Richard Gullan, FRCP FRCS Consultant Neurosurgeon King’s College Hospital, London, UK
Copyright of British Journal of Neurosurgery is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
OBITUARY His neurosurgical training started under Mr. Johnson and Mr. Dutton in Manchester, where he was highly influenced by the very positive and active operative teaching, especially with Mr. Johnson, who during a period of considerable absence from the unit asked John to look after his private patients – a tribute indeed to any senior trainee. He then moved to the Radcliffe Infirmary, Oxford to complete his training with Mr. Pennybacker and Mr. Potter. The founding neurosurgeon of the Neurosurgical Unit at the Brook Hospital in Woolwich, Mr. Geoffrey Knight was retiring. His main interest was the treatment of affective disorders, especially depressive illness with a modified frontal leucotomy technique, performing a subcaudate tractotomy using stereotactically placed Yttrium-99 seeds. John had a wide range of surgical skill particularly the removal of difficult tumours including acoustic neuromas. The flavor of the post on offer was not entirely to his liking, but Mr. Pennybacker encouraged him to “go for it”, confident that John would, with his excellent surgical skills soon do the sort of neurosurgery he really wanted to pursue! So in January 1971 he moved to Blackheath, near “The Brook”, to start work alongside Mr. George Northcroft and Mr. John Gibbs. As a new consultant he engaged in most aspects of the specialty but also was a forerunner of sub-specialization and in particular refined his surgery for tumours, bringing into play the CUSA, LASER and microsurgery during their early introduction to neurosurgical practice, having been one of the first neurosurgeons from the UK to go to study microsurgery with Professor Yasargil in Zurich. He continued a heavy commitment to psychosurgery alongside Dr. Paul Bridges, the consultant psychiatrist, co-authoring numerous publications. The field aroused much controversy, but despite sometimes extremely aggressive hostility from those determined to see this work stopped, they stayed supportive and remained strong advocates for the patients, all refractory to every other method of treatment and desperate. They knew this type of treatment was an absolutely “last resort” and but it helped many to be freed from institutional care. Enabling this “lesion” producing type of treatment to continue has acted as a crucial springboard for today’s renewed interest in less controversial deep brain stimulation techniques. The quirks of the aging Victorian Brook Hospital, gave him opportunity to employ his photographic skills with colleagues too, receiving the Bronze award in the 1988 Blithe and BMA Film and Video Competition, for ‘Psychosurgery: A Last Resort’, a stimulus for the BBC2 QED programme broadcast in March 1990. He became an Associate of the Royal Photographic Society in 1993 when he presented a panel of pictures depicting daily life in the Brook. “JRB” trained numerous doctors. As a newcomer one was immediately fired by his enthusiasm, energy, and pride in the unit, and everyone he worked with. His great intellect was instantly evident, as also the fondness and respect shown to him by staff of every level. He wasn’t a lover of formality and
John Bartlett: A tribute to a distinguished and much loved neurosurgeon who worked through a period of extraordinary change
Fig. 1. John Bartlett.
18th January 1934 – 6th January 2014
Consultant Neurosurgeon (1971–1998); President of the Society of British Neurological Surgeons (1996–1998) John Richard Bartlett (Fig. 1) was born in Saffron Walden in 1934. Aged ten he was given a book “The Boy Electrician”. The subject crystalized a lifelong passion for science. His grandmother searched out the plates and box cameras taken to Africa by his grandfather Sir John Kirk during explorations with Livingstone in the 1860s, starting a lifelong interest in photography. In 1947 he went to Radley College where he was introduced to rowing, his main sport during school and college years. Uncertain of what to do after school he considered engineering, but as his grandfather, both parents, and an aunt were doctors and an uncle, Sir Almroth Wright, engaged in medical research, he was led inexorably to medicine, reading Natural Sciences at Peterhouse College, Cambridge and Medicine at St Mary’s Hospital Medical School, qualifying in 1958 and then appointed House Surgeon to Sir Arthur Porritt. A junior post at the Midland Centre for Neurosurgery, working for Dr. Bickerstaff and Mr. Small, and a nine month spell in The Birmingham Accident Hospital with Prof. Gissane and Mr. London convinced him that he wanted to become a Neurosurgeon, obtaining his FRCS in 1966. 300
Obituary you became a true apprentice, learning by “osmosis” and encouragement to do your best. His inspirational teaching was instrumental in many becoming distinguished physicians and surgeons. He made a point of his trainees becoming excellent future “ambassadors” of the unit. As a clinician he was excellent, in the style of a good neurologist, taking a careful and probing “history”, really listening to the patient, and examining them sensitively and carefully – looking for little clues, however small. Policies and protocols were not for him! “Why go to medical school unless it’s to learn to understand the natural history and pathology of disease and above all think!” But of course managing complex conditions involves far more than this. “You can make a diagnosis, but what are you going to do about it?” He would often say. With his absolute passion for science in its broadest sense and his supreme logic he would work out from “basic principles” the best way to solve the task at hand (a message he would frequently convey to his own children helping them with homework!), all done under a beguiling veil of calm kindness, and empathy. He would weigh up with precision the optimum treatment for each individual, fully taking into account the real and often forgotten limitations of modern neurosurgery at its best, and also the limitations that might exist for the patient. His love of learning and generous teaching style were deeply intertwined with a visionary fascination for modern technology. As computers became available John spent many happy hours with his four children, trainees and colleagues, leaning to manage systems and develop programs. These skills were used to good effect in driving forward the computerization of the Neurosurgical Unit clinical records system well in advance of other centers, and presenting this work to the Society of British Neurological Surgeons (SBNS). He was involved in several major publications on the use of CT scanning in its infancy, the Brook Unit having one of the very first CT scanners in the World. Various other allied publications on the economic evaluation and implications of new diagnostic equipment were also undertaken, including a paper in the British Medical Journal with, amongst its authors, Sir John Banham, who become Director General of the Confederation of British industry. Later he pioneered hard to get access to MRI, immediately seeing its huge potential and the revolution it would cause in spinal imaging and diagnosis. Glenn Neil-Dwyer, Michael Sharr and Richard Gullan, his most long standing neurosurgical “working colleagues” agree that in the operating environment John was supreme. His ability to handle the brain with the gentlest of touch, whilst moving the operation forwards with a perfect pace of dissection was legendary. The results spoke for themselves. His close anaesthetic colleagues David Hurter and Lorice Songhurst loved working for him because there were no “unexpected moments of excitement”, so much loved by filmmakers but hated by truly professional surgeons. As he would say “if things seem exciting it always strikes me that perhaps something has gone wrong”. As a trainee one would be so easily tricked into thinking this was easy, just as we all are when we watch any world-class musician or sportsman at work!
301
His earlier career was blighted by political indecision and uncertainty over the future of the Brook Unit. Varieties of options were considered, often in much time-consuming detail, and resulting in confrontation between various parties involved. Almost 30 years after the initial Ministry of Health meeting in 1967 to rationalize neurosurgical provision for the Metropolitan Regions the Brook Unit was amalgamated with the Guy’s/Maudsley Unit within King’s College Hospital in 1995 to form a single Neuroscience Centre for SE London, East Sussex and Kent. However in management he held the total respect of his peers. As a result he chaired any committee with quiet but determined authority, tempered with the occasional timely and strategic political salvo to someone in “high places”, akin to a sniper’s bullet! These skills were a great asset during his Presidency of the Society of British Neurological Surgeons at a time when there was much need for change. He was highly instrumental in revising the Society’s constitution and structure to make it fit for purpose in a rapidly modernizing speciality within the Health Service. Once established in King’s, as the senior consultant neurosurgeon he showed great leadership and was determined to make the unit flourish, despite all the past conflict and bitter last minute decision to cancel the construction of a new purpose built unit that had been fully designed and should have opened on the Maudsley site in 1995. He rapidly engaged with new colleagues to help create two of the busiest services for pituitary and acoustic neuroma surgery in the UK. His lifetime dedication to the concept of keeping neurosurgery safe was amply shown by his determination to encourage good team working and the preparation of important SBNS documents within the framework of the Royal College of Surgeons, resulting in his much deserved election as President of the SBNS at the close of his clinical career. In retirement photography became his main hobby and many people will remember him with his camera around his neck and seeing exhibitions of his work, often carried out on holidays in “remote” places. He was President of the Bromley Camera Club for its centenary year and London Organizer for the Royal Photographic Society. He always had time for anyone who was starting out on their photographic adventure and would give what help he could, teaching all four of his children use of the camera, the darkroom, the principles of light and composition, and being rewarded by three of them taking up professional careers in photography and film. This very special man and true “doctor” displayed a passion for the welfare and care of his patients, leaving a great legacy behind him. He was a perfect model for neurosurgical determination and vision, tempered by great modesty, grace and humility. His sad loss from unrelenting prostate cancer can never be filled; supported throughout by his devoted wife Cilla, a pillar of strength to him at every corner of his glowing career, and his deeply loved four children and grandchildren. Richard Gullan, FRCP FRCS Consultant Neurosurgeon King’s College Hospital, London, UK
Copyright of British Journal of Neurosurgery is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
