Obituary: John Keith Brown, inspirational child neurologist at Edinburgh Sick Children's Hospital
Dr John Keith Brown will always be remembered for his work as a paediatric neurologist at the Sick Children’s Hospital in Edinburgh. His name, Keith Brown, or JKB as was his familiar label, was for more than 30 years synonymous with this specialty and hospital.
After graduating MB ChB in medicine from the University of Manchester in 1961, Keith was the last house surgeon to the famous British neurologist and pioneering neurosurgeon Sir Geoffrey Jefferson CBE, FRS. His time as a registrar at the David Lewis Centre for Epilepsy was pivotal for Keith, because here he came under the influence of Dr Neil Gordon, a gentle and learned neurologist who became one of the founder fathers of the specialty of paediatric neurology in the UK.
He first came to Edinburgh in 1966. At this time Edinburgh was a hotbed of child neurology innovation and academic output, led by Dr Tom Ingram whose academic brilliance brought out the neurological talents of Keith Brown and others. This fledgling department of Paediatric Neurology developed and flourished in a small hut-like ward alongside the main children’s hospital.
As a research fellow in neonatal paediatric neurology at the Simpson Memorial Maternity Pavilion, under the academic guidance of Prof John O Forfar, Keith undertook studies on neonatal asphyxia and birth injury. Professor Forfar remained an influential supporter and mentor of Keith.
From 1970 to 1973 he was senior registrar in paediatrics and neurology at RHSC, during which time he completed his training and was then appointed in August 1973 as consultant paediatric neurologist and elected to the Fellowship of the Edinburgh college in 1975.
Keith remained consultant paediatric neurologist, and part time senior lecturer and consultant in administrative charge of paediatric neurology for the whole of his working life at the Royal Hospital for Sick Children until his retirement.
Keith was an accomplished clinician widely sought after for his opinion. Children particularly liked his engaging “upfront” manner and ‘high five’ greeting.
He promoted the concept of joint care for children who require the services of both neurologist and neurosurgeon. This culminated in the building of a new combined ward in the hospital, named after his emeritus colleague – the TTS Ingram ward. This advance has since been emulated elsewhere.
For Keith Brown there was a seamless merging of clinical, teaching and research, each dependent on the other.
Keith Brown was a gifted teacher of paediatrics, and arguably the best teacher of his generation. His teaching reputation spread internationally. He taught postgraduates according to whether they wished to be recognised as general paediatricians with a special interest in neurology, community paediatricians running developmental assessment units, or card- carrying paediatric neurologists.
The staff he taught and trained are now the leaders of our specialty in Edinburgh, and throughout the United Kingdom and all remember him with much gratitude. There are also more than 40 other leading paediatric neurologists, wholly or partly trained by Keith in Edinburgh, Austria, Canada, Greece, Egypt, South Africa, Hong Kong, Singapore, Kuala Lumpur, Nigeria, Thailand and Saudi Arabia.
The teaching ward rounds on Friday mornings were a wonderful learning experience but not without humour.
Keith’s lecturing style was interactive. The unknowing or newcomers sat in the front seats only to find they were often targeted with questions – this could be embarrassing especially for visiting seniors, even Deans and professors.
Keith’s career was dotted with many special presentations and orations. He had in excess of 300 communications, including some 15 special orations which were as lecturer, distinguished guest lecturer, visiting professorship lectures, or named lectures.
Keith was always in demand for teaching and lecturing to students in other disciplines – educational psychology, speech therapy, special education, nursing, occupational therapy, midwifery, health visitors, teachers of the deaf, and teachers of the physically handicapped.
Research to Keith was an absolutely essential part of good practice, without it, one’s teaching would remain static and fixed in time, as would patient care and management.
After Keith’s initial research in newborn neurological conditions, in which he became an expert on birth asphyxia, much of his subsequent research was carried out in conjunction with junior and senior colleagues, where he frequently was the instigator, monitor and supervisor. His publications (of all types) number 200.
Keith’s broad areas of special research interest, and where he was a leading light, were various topics in neonatal neurology, childhood epilepsy, learning disorders, motor disorders including cerebral palsy, and the effects that these neurological conditions have on the child’s functioning.
He had excellent gestalt function. While most people would be bogged down with the detail from a plethora of facts in numerous publications on a topic, Keith was able to home in on the important facts from an article, and see the way forward. Keith trained in a time when clinical examination was the only investigatory tool available to the neurologist.
Keith was charged with many Commissions of Trust, including responsibilities for undertaking final examinations in medicine in Edinburgh and Glasgow; membership examinations for 20 years, speech therapy degree exams, Open University examinations, as well as PhD and MDs in Edinburgh, Oxford, Dundee, and Cape Town.
A major assignment was his position as senior editor of the main international journal of paediatric neurology – Developmental Medicine and Child Neurology – for 20 years. Much responsibility fell to him for reviewing and decision making about submissions, writing editorials etc. Keith had a long friendship and working relationship with Dr Martin Bax who was then the chief editor.
Beyond work his interests were dining out and music, and most especially, organ and church music.
Keith always had a love of organ music, ever since his days as a student and as a young doctor in Manchester, when he would find time to visit Manchester’s Anglican Cathedral to listen to lunch-time organ recitals and choral performances.
He taught himself the organ including pedalling. He once bought himself a sizable electronic organ with pedals, and unwisely located it in the first floor drawing room in his house in the Grange, only to find a short time later that it had caved in through the floor and damaged the ceiling of the room below.
All of us who knew and worked with him will miss Keith. To us, especially, Keith Brown was a long-time friend, a colleague and a support from our earliest days in Edinburgh,
This is a sad time for those who knew and loved Keith, especially his wife Anne, whose devotion and tireless care during his last protracted illness was exemplary.
We also feel for his daughters Mhairi and Fiona, and his sons Neil and Andrew, and also for his former wife, Frances.
We will remember him with fondness and appreciation.
Robert A Minns & Paul Eunson