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William Pickles an Address Given at a Memorial Service in the Church of St Emmanuel, Leeds, on 23 April 1969

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William Pickles an Address Given at a Memorial Service in the Church of St Emmanuel, Leeds, on 23 April 1969 LECTURES AND ADDRESSES William Pickles An address given at a Memorial Service in the church of St Emmanuel, Leeds, on 23 April 1969 PROFESSOR JOHN PEMBERTON, M.D., F.R.C.P., D.P.H.* W ILLIAM NORMAN PICKLES was born in Camp Road, Leeds, on 6 March 1885. It was on the same day of the year that his funeral service was held in Aysgarth Church. He would have been 84 on that day. It was a cold sunny afternoon, the last of the winter's snow melting under the dry stone walls, when the men and women of Wensleydale who had been Will Pickles' patients crowded into Aysgarth Church to pay their last tribute. He had been their family doctor for 51 years. Today the whole medical profession honours him, not only for his long and devoted service to his patients as an outstanding general practitioner, but also for his contributions to medical knowledge in the field of epidemiology. We also honour him for enhancing the reputation and advancing the status of the branch of medicine which he loved and faithfully served throughout his professional career. In spite of temptations to leave general practice, to concentrate on epidemiological work in the Ministry of Health for example, he never even considered leaving Aysgarth. In fact he once said: "I would not have spent my life elsewhere for all the wealth of the Indies". He remained a general practitioner until his retirement in 1964. However, he also held the appointment of part-time medical officer of health for the rural district of Aysgarth for many years and this stimulated his interest in epidemiology. Will, and I must refer to him as Will, because that is the name that all who knew and loved him used, was the son of a Leeds general practitioner, John Jagger Pickles, and his earliest memories were of the life of a busy, city general practitioner. The drama and interest of his father's work, largely among the poor people of Leeds, made it almost inevitable that he should follow in his footsteps as his older brothers had already done. He entered the Medical School of Yorkshire College, which was later incorporated in the University of Leeds, in 1902. He was Lord Moynihan's dresser for six months when he started in the General Infirmary and Moynihan took a special interest in him. Years later when he published one of his early papers Moynihan wrote to him and said: "What you are doing is all to the good of British medicine". His first qualification was the Licentiate of the Society of Apothecaries and after doing some locums in general practice he returned to the Leeds General Infirmary as resident obstetric officer and later took his London M.B. He then returned to a variety of locums in general practice including one in Bedale where he worked for the late Dr Eddison, another distinguished Yorkshire general practitioner. I visited Dr Eddison in Bedale about 20 years ago and he talked to me about Will. "Will was an extraordinary likeable chap" he said, "got on well with his patients and a great one for keeping statistics and records and so on. He's been very good on the local executive committee-persuasive and tactful. I don't think he's got *Professor of Social and Preventive Medicine, Queen's University, Belfast. J. ROY. COLL. GEN. PRAcrrr., 1969, 18, 5 6 JOHN PEMBERTON any enemies in the district". He could have said "in the world" because Will Pickles had an extraordinary gift of friendship. He always made the visitor welcome, whether he was, perhaps, a rather troublesome patient, or a distinguished doctor from halfway across the world. He loved his patients-even the most difficult, and of these he would merely say: "He's rather a poor old thing". His patients loved him because he always found time to talk to them and was genuinely interested in them. They were proud of him too. In the first world war he served in the Royal Naval Volunteer Reserve and during this period he became engaged to Gertrude Tunstill and they were married in Aysgarth Church in 1917. He obtained his M.D. London by examination the next year and on returning to Aysgarth he resumed his partnership with Dean Dunbar which was to prove so happy and rewarding, until Dunbar's untimely death from a pulmonary embolus in 1937. Will was delighted to return to Aysgarth after the first world war and to settle down with his young family to work with a partner who had been a fellow student with him. Indeed he might well have been content to live out his life as a good and much loved country doctor. In 1926, however, he came across a book by another general practitioner entitled The principles of diagnosis and treatment in heart affections by James Mackenzie. This book made a great impression on him and the next year, at the age of 42, he set out on the path which was ultimately to make him famous. In order to bring his knowledge up to date he began, first to take correspondence courses, and then to attend refresher courses in London or Edinburgh. There were no grants for the postgraduate education of general practitioners in those days and if it had not been for the loyal support of his partner he would never have been able to go to these courses. "You go, Will" Dean Dunbar would say to him "and come back and tell me what you have learned". At about this time an epidemic of jaundice started in the Dale and Will started to keep records of all the 118 cases that he and Dunbar saw. There was little known about this disease then and its infectious nature was not generally recognized. By Sherlock Holmes-like methods of enquiry they were able to track down an additional 132 cases and to establish the source of infection in many cases and the range of the incubation period. Will was always on the look-out for what he called the short and only possible contact in order to establish accurate incubation periods for infectious diseases. The account of this enquiry was published in the British Medical Journal in 1930. Will went to see Dr Alison Glover, chief medical officer at the Ministry of-Education, about different estimates of the incubation period which had been given and Glover suggested a method of recording epidemics on charts which Will followed for the next 25 years. In his work he had the skilful and continuous help of Mrs Pickles who main- tained the charts over all these years. In fact Mrs Pickles-Gerty-kept the charts beautifully and meticulously and Will never failed to mention in his lectures the great help that Gerty had given him. An article on an outbreak of Sonne dysentery soon followed and then a classical description of an outbreak of Bornholm disease-a condition which, until Will's descrip- tion appeared, was practically unknown and unrecognized in Britain. In 1934 he met Professor Major Greenwood in London. Greenwood already knew of Will through his articles and now recognized him as a successor to Jenner and Budd, who were also general practitioners who had made important contributions to epidemi- ology. He suggested to Will that he should write a book on his findings. Will often said: "I've had a lot of luck in life" and he frequently acknowledged the help and encouragement that Alison Glover and Major Greenwood had given him. As is now well known he went on and wrote, between evening surgery and dinner time, the WELLIAM PICKLES 7 slender book which made him world famous. Epidemiology in country practice was published by John Wright of Bristol in May 1939. It was well received and but for the war he would almost certainly have achieved a world-wide reputation sooner. Unfor- tunately the whole remaining stock was destroyed in an air raid in 1941. Epidemiology in country practice had, however, made its mark. In 1942 he wrote, but (because of war-time conditions) did not deliver, the Milroy lectures of the Royal College of Physicians on "Epidemic disease in English village life in peace and war". The next year John Gordon, who was professor of epidemiology at Harvard and was serving in the U.S. Forces in England, asked at the Ministry of Health if he could meet Will. The powers that be said: "Certainly we will invite him to London to meet you". "No sir" replied Gordon "I want to go and see him in this Goddam little town where he does his epidemiology". And so Gordon came to Aysgarth and as a result Will was invited to give the Cutter Lecture at Harvard in 1948. This was the first of a series of lecture tours that he was invited to undertake in the U.S.A., Australia and South Africa. Everywhere he went he made many friends among the leading medical men of his time, among the general practitioners to whom he gave a new interest and great encouragement and among ordinary folk doing ordinary jobs. Medical students who might have gone to his lecture in a slightly blase frame of mind ended witn rapturous applause. In the end he had lectured to students in practically all of the medi- cal schools in the United Kingdom, and to many students he gave a new vision of the art and science of medicine as their letters and subsequent visits to Will in Aysgarth showed. In the 1950s his advice was much sought after and he became a member of many committees including the Medical Advisory Committee of the Central Health Services Council and the Nuffield Provincial Hospitals Trust Medical Advisory Council.
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