Obituary: William Michael Garraway, professor of public health

Mike Garraway: Professor of public health whose pioneering research into stroke care changed lives
Mike Garraway: Professor of public health whose pioneering research into stroke care changed lives
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Born: 26 January, 1942, in Dumfries. Died: 31 May, 2014, in Fortrose, aged 72

Many patients make a good recovery following a stroke and will be unaware that their return to normal life is due in part to the pioneering research of Professor Michael Garraway. In the early 1970s, stroke was a common disease causing death and disability, but was overshadowed by heart disease, which was perceived as a more important condition.

Specialist coronary care units were established to treat heart attack patients but stroke patients were managed only in general medical wards.

Michael Garraway and others thought that stroke patients might also benefit from specialist care in dedicated units comprising physiotherapists, occupational therapists, nurses and physicians.

In those days, experimental trials of new methods of delivering care were uncommon, but Michael Garraway and Dr Anwar Akhtar at the Royal Victoria Hospital in Edinburgh set out to evaluate a new model stroke unit in the hospital. They showed that stroke patients treated there did indeed fare better than those in the medical wards. This research led eventually to the establishment of stroke units throughout the NHS and Western world.

Michael Garraway – “Mike” – was born in Dumfries in 1942. He was educated at Dumfries Academy and Carlisle Grammar School and from there proceeded to the University of Edinburgh where he studied medicine from 1960 to 1966.

His lifelong interest in medical politics began at this early stage and he was elected president of the British Medical Students’ Association.

Following house officer posts in hospitals in Edinburgh and a brief period in general practice in Cumbria, he was awarded a Department of Health Fellowship to study epidemiology and public health at the London School of Hygiene and Tropical Medicine.

He was subsequently appointed lecturer in Community Medicine at the University of Edinburgh and, after a year at the Mayo Clinic in the United States, was promoted in 1978, on the recommendation of Professor Sir John Brotherston, to senior lecturer.

Three years later, however, he was persuaded to return to the Mayo Clinic as head of the Section of Clinical Epidemiology, a position he held until his return in 1983 to Edinburgh to take up the Bruce and John Usher Chair of Public Health (the oldest chair of public health in the UK, established in 1898).

From 1983 to 1997 as head of the Department of Community Medicine (later renamed Public Health Sciences), Mike undertook a major revitalisation of the department involving a huge expansion in research and teaching. He relished in the political intrigue and competition for resources.

At the same time he was highly supportive of many colleagues and took a personal interest in the progress of every postgraduate student.

During his tenure, numbers of staff increased from 20 to nearly 100, postgraduate students from six to more than 60, and annual research income from £100,000 to £2.3 million.

This was coupled with his insightful vision that the department would benefit from relocation from isolated accommodation in the Usher Institute in Warrender Park Road to renovated facilities in the heart of the Medical School.

While guiding his department through a period of major change, Mike continued his own research. He was one of the UK’s leading chronic disease epidemiologists of his generation and the quality of his research was of the highest standing.

His early research on stroke units and day care surgery was exemplary in demonstrating how high quality trials could be carried out in the clinical setting. Others have subsequently pursued this approach but few with the attention to detail and the objectivity upon which Mike insisted.

He abhorred “useless research”. In the USA he conducted important studies on the epidemiology of stroke and was the first to demonstrate the declining incidence.

He carried out a major population study of benign prostate disease and was instrumental in developing, defining and rigorously testing methods of measurement which could be used by other epidemiologists.

The innovative approach and high quality of his research resulted in publications in the leading medical journals. He maintained a broad public health focus encompassing not only epidemiology, but also economic and sociological perspectives.

Mike had a national and international reputation as an epidemiologist. He was Fellow of the Royal College of Physicians of Edinburgh, Royal College of General Practitioners, and the UK Faculty of Public Health.

He was adviser to the World Health Organisation, National Institutes of Health (USA), Medical Research Council, and other research bodies in the UK. He held Travelling Fellowships from among others the Council of Europe, British Council, Royal Society and Carnegie Foundation. He was secretary of the International Epidemiological Association, member of the editorial boards of several international journals, and frequently invited to be external examiner in the UK and overseas.

From 1976 to 1995 he gave more than 200 presentations to symposia, scientific meetings, and institutions in more than 20 countries.

During an academic career in public health spanning 27 years, with 21 spent in the University of Edinburgh, Mike enhanced the standing of the university in this field. His energetic, rumbustious, proactive style of management did not suit everyone but, coupled with enthusiasm for his subject, enabled the Department of Public Health Sciences to become a leading academic department of its kind, a position which is still maintained today.

However, for Mike, ongoing health problems were taking their toll and he retired early at the age of 55. He continued to work part-time on behalf of the university, carrying out epidemiological studies of rugby injuries for the Scottish Rugby Union.

Being an enthusiast for all things Scottish, Mike and his wife, Alison, moved permanently to their home in the Highlands. Visitors were given a warm welcome and encouraged to take to the outdoors for mountain biking, hill walking and canoeing.

Mike continued as a member of the Alvis Owners’ Club, volunteered as a prison and custody visitor, and raised funds for charity. However, although never admitting as such, he gave the impression that he missed the academic and medical world that had been so much of his life and for which he will be well remembered.

During recent years, Mike’s health and ability to exercise deteriorated and, formerly very active, he found this frustrating. He was, however, ably supported by Alison, son Andrew and daughter Kate, until he died at home in Fortrose on 31 May, 2014.