Professor Sir David Weatherall (1933 – 2018)

Here is the Guardian’s remembrance of David. It highlights his work with us over 23 years:
https://www.theguardian.com/science/2018/dec/16/sir-david-weatherall-obituary

We lost David on December 8, 2018. A great deal has been written about life and times, and the accomplishments, awards and honours rightly conferred on him.

But here, I want to capture some of the essence of the David Weatherall who was part of the loving, and grateful, family at Hemoglobal.

“Careless of Fame”

David was wise, selfless, thoughtful, generous, quick to laugh, and the funniest person on earth.  He was truly “careless of fame” (although, rightly, it pursued him) which, as he reminded us in the introduction to his 1995 book Science and The Quiet Art, was Virgil’s description of the ideal physician.

A clinician like no other, he was attentive to all details.  To work with him was an education and an inspiration.  He maintained every scientific discovery had arisen from an observation in a patient.  When he worked with lesser mortals (everyone else) he didn’t so much demand from you, as discern your abilities (paying attention; never criticizing).  He showed unparalleled grace to students and trainees and was never afraid to be enthusiastic.  In fact, I grew to realize that he would express enthusiasm about drafts of papers that were unequivocally terrible, but always follow kind words with line-by-line refinements, making every paper, in every way, better.

He was undemanding of everyone but himself.  Brilliant, he never uttered a self-aggrandizing word.  With classic self-deprecation he claimed he was well placed to write on the subject of his book The New Genetics and Clinical Practice because he “appreciated the plight of his fellow clinicians” (who were, certainly unlike David, possibly genuinely confused about the subject).  He lacked a nasty edge.  He didn’t so much dislike pettiness as have no time for it.  (He rarely complained, aside from occasions on which the “lads” – his beloved Liverpool football club – failed to distinguish themselves.  At those times, he complained a lot).

We worked together for 23 years, including nearly 100 trips, most to Sri Lanka.  David’s good humour never wavered through the days, and years, of surviving on desiccated noodles, cold fried eggs, and expired Nescafe, in a local hotel which rivalled Faulty Towers in comfort (marginal plumbing; uninvited local fauna).  Over many late evenings we (students, colleagues including Angie, Laura, Giulia, Amir, and many others who loved him) would laugh for hours.

Years into conducting research in Sri Lanka, David, our colleague Dr. Angela Allen (his fellow Liverpool native), and I decided to co-found Hemoglobal® (www.hemoglobal.org) to improve care for patients with blood diseases in Asia.  But well before that, conscious of his responsibility to the poor and marginalized, David had spent years working with disadvantaged populations with thalassemia.

Our Longest Journey Together

As well as working with the patients who needed him most, David also put his quiet courage into action in the interests of scientific integrity and the protection of patients.  From 1996 and for nearly two decades after that, he confronted powerful academics at the University of Toronto and Toronto’s Hospital for Sick Children who took action against me.  David was the center of “The Gang of Four” – my courageous colleagues, scientists Helen Chan, John Dick, the late, mourned Peter Durie, and Brenda Gallie — who, along with me, faced harassment and threats from the University and Hospital after I had raised problems in a trial I had been conducting in children with thalassemia.  The company Apotex threatened “all legal remedies” if I revealed my concerns. https://www.caut.ca/issues-and-campaigns/academic-freedom/academic-freedom-cases/dr-nancy-olivieri 

The administrations of the University and The Hospital for Sick Children sided with Apotex, took actions against me, and disrupted my work including repeated dismissals.  As our colleague Professor Arthur Schafer would observe, “Some were led to speculate that the university’s failure to recognise and support Olivieri’s academic freedom might not have been unconnected to its eagerness to secure financial support from Apotex for the university’s proposed molecular medicine building project.” https://www.ncbi.nlm.nih.gov/pubmed/14872066

Then David Weatherall became Toronto’s biggest problem.   David and his close friend, Dr. David Nathan, were the greatest obstructions to those actions years ago.  They wrote about the experience then and later, at: https://www.nejm.org/doi/full/10.1056/NEJMsb020394 “The Davids” ensured that the University of Toronto could not succeed in efforts to re-write this disgraceful chapter of its history.  Those were times in hell.  But we were never alone.  (Possibly, the University of Toronto may be the only place on the planet where David Weatherall is not mourned).

David was also one of a handful of UK academic clinicians to have challenged Sheffield University over the abuse of Dr. Aubrey Blumsohn by Procter and Gamble and their bankrolled researchers.  Aubrey has observed, “David’s letter to Sheffield University 13 years ago was understated, careful, and devastating.  It showed the University that it was being watched.  Almost none of the rest of medical leadership in the UK could measure up to David years ago, and fewer today.” http://scientific-misconduct.blogspot.com

David continued many lifelong friendships with fellow ethical resisters including Arthur Schafer, Marc Giacomelli and Jon Thompson, who met during this 20-year struggle (culminating, but not ending, in a mediated settlement with Apotex in late 2014).

David Weatherall’s decades of friendship with David Nathan, incorporating mutual personal and intellectual respect along with years of laughter, was that which he experienced with no one else.

David was physically, as well as morally, courageous.  Twenty years ago, he ruptured both quadriceps tendons after slipping in a temple in Bangkok (“that should teach me to avoid organized religion”) and made an unpredicted, complete recovery due to sheer determination.  When he and I faced a charging herd of elephants in Sri Lanka, I cowered in the jeep; David was more bemused than agitated.  We escaped with our lives, and I write this with more gratitude than I felt at the time, as I contemplate those years without David.

He loved: Mozart’s Clarinet Concerto.  Anything by Mozart.  Angela Hewitt.  Glenn Gould.  Walking in the English hills.   Dawn in Asia.  Late evenings in Sri Lanka.  His pipe.  Marzipan.   Cats (usually too respectful of his own to evict it from in his office chair, he often stood to talk).  Coffee, containing a disturbing concentration of artificial sweetener, and drunk all day.  Inspector Morse.  The great sopranos. Nicknames.  Thomas Hardy.  Goldsmith, especially: “those who pant for the vulgar praise that fools impart.”  Nasi Goring.  The early evening light over Oxford, from Wytham.  California, including times with Elliott.  The museums of Oxford.  The Liverpool poets.  The Liverpool football club, even when it lost.  Talking about the Liverpool football club when it lost.  William Osler.  His mother tongue (of many books exchanged over the years, a favourite was “Lern Yerself Scouze.”)  Telling stories of old Liverpool.  His family.  Us.

He disliked: Being the center of attention.  Those who promoted expensive therapies in countries where even safe blood is not available to many patients.  Anyone and anything pompous.  Computers.  The erosion by commerce of the evidence base of medicine.  Most vegetables.  Flying.      

We live in his debt

Over all the years of work in Sri Lanka, David made seminal scientific contributions to the understanding of the still-incompletely-understood clinical variability in Hemoglobin E thalassemia (the most common form of severe beta thalassemia worldwide, and very common in Asia including Sri Lanka), never failing to involve the local physicians caring for the patients in any study.  He trained young people from Asia who, thanks to him, returned home after graduate studies in Oxford to care for patients and conduct further research.  

He never made the calculation ‘how will this help my career?’   This would no more have occurred to him than to stop working.  His considerations were always of patients, on which all aspects of his scientific work were directed and all his curiosity focused.  He took seriously the advice of Hippocrates: he was loyal to the profession of medicine, and he was just and generous to its members.  His generosity extended not only to his time and his knowledge but to practical support.  David understood better than anyone that to help “North South” partnerships to flourish, one needed not only to train, but subsequently to nurture and support over extended periods, physicians working in more difficult conditions in low-resource countries (where many physicians work two shifts to survive, limiting time for curiosity-driven research).  

He was loyal to his colleagues Adrian Basnayake and Dr. Shathimala De Silva, who had first invited him to Sri Lanka, and to his former student Dr. Anuja Premawardhena who, after Oxford, returned to Sri Lanka to become Professor in Medicine in charge of adult thalassaemia care in Colombo, where patients were living to adulthood because of David. He loved working with many other beloved colleagues and students in Sri Lanka and elsewhere, including Liz Rose for her dedication, and particularly working (and supporting Liverpool) with Dr. Angela Allen.

To write that he was brilliant, kind, capable, fearless, tough-minded, understanding, sensitive, unselfish, encouraging, enthusiastic and warm, the greatest hematologist of all time, a friend of the poor, the person who made it possible that thousands of children grew to adulthood, and the primary inspiration to many lives, is entirely inadequate.  We live in his debt forever.

There is a land of the living and a land of the dead and the bridge is love, the only survival, the only meaning.
Thornton Wilder, The Bridge of San Luis Rey

That’s all there is.  The love David had for us; the love we had for him.  And I know that he is with us, and in those moments when I talk to him, I have to believe he is listening.  Inspired by his character and grace, we will struggle to continue his work.

Nancy Olivieri
December 2018

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