January 1981 Vol 45 No 1 British Heart A monthly journal of cardiology publisl~edin associatio~,wit/, the Britisl~Cardiac Society Journal A tribute to Walter Somerville Editorial Dennis Krikler 1 Significance of minor ST segment and T wave changes in the resting electrocardiogram of Atr appreciation of Walter Sonierville asymptomatic subjects M Joy, D W Trump Jolin Goodwin 3 Relation between QT interval and heart rate. "In Dublin's fair city". Walter Somerville: the New design of physiologically adaptive cardiac early years Eoin O'Brien 5 pacemaker A F Ricka:ds, J Norman Walter Somerville: a tribute Simon Dack Sinuatrial disease in young people A F Mackintosh Walter Somerville Frits L Meijler 11 Walter Somerville-notre ami britannique Anatomico-electrophysiological correlations in 12 the conduction system-a review R H Anderson, A E Becker, J Tranum-Jensen, M J Janse Social class and coronary heart disease G Rose, M G Marmot 13 Relation between atrioventricular pathways and ventricular response during atrial fibrillation and Rastelli procedure for transposition of the great flutter E Rowland, P Curry, K Fox, D Krikler arteries, ventricular septa1 defect, and left ventricular outflow tract obstruction. Early and late results in 41 patients (1 971 to 1978) Pathological view of sudden cardiac death A L Moulton. M R de Leval, F J Macartney, Michael J Davies J F N Taylor, J Stark 20 Case reports Regional non-uniformity of left ventricular wall movement in man R A Greenbaunl, D G Gibson 29 Congenital aneurysm of left atrial appendage D A Bramlet, J E Edwards Cardiac pain at rest. Management and follow-up of 100 consecutive cases N Brooks, Carole Warnes, M Cattell, R Balcon, M Honey, Congenital fistula between left ventricle and coronary sinus Katherine M J McGarry, C Laytori, M Sturridge, J Wright 35 J Stark, F J Macartney Reappraisal of lignocaine therapy in management of myocardial infarction B L Pentecost, J V De Treatment of paroxysmal nodal tachycardia by Giovanni, P Lamb, P J Cadigan, K L Evemy, dual demand pacemaker in the coronary sinus 42 D B O'Keeffe, P V L Curry, E Sowion ASTM CODEN: BHJUAV 45 (1) 1-108 (1981) "IN DUBLIN'S PAIR CITY" WALTER SOMEHVILLE: TIiE EARLY DAYS BY EOIN O'BRIEN Reprinted from British Heart Journal Volume 45, No. 1, pages 5-8, January 1981 COPYRIGHT @ 1981 BRITIS~IHEART JOURNAL ALL RIGHTS OF REPRODUCTION OF THIS REPRINT ARB RESBRVBD IN ALL COUNTRIES OF THE WORLD LONDON BRlTISH MEDICAL ASSOCIATION TAVISTOCK SQUARE, WClH 9JR Br Heart J 1981; 45: 5-8 "In Dublin's fair city" Walter Somerville: the early years EOIN O'BRIEN Frorn Tlte Charitable Itlfirrnary, Jervis Street, Dublirr Walter Somerville was born on 2 October 1913 in was built for the second Earl of Belvedere in 1786 Clontarf, then a snlall seaside suburb of Dublin. by Michael Stapleton whose reputation as "the His father Patrick was a Dubliner and his mother Dublin nlaster of the silver age" is truly exemplified Catherine came from Kosconlnlon. Walter joined in the extravagant plaster and stucco work of the his 2-year-old sister Bilecn to co~npletea close and generously proportioned halls and rooms. The happy family. In the early years of the century few Diana Room or Library complete with the original places could have vied wit11 Clontarf for scenic mahogany organ and book cases, and the Apollo beauty, and the variety of pleasure available to lioom with its ornate ceiling survive unchanged, young children was incomparable. l'he sea of but in the Venus Rooni the centre piece of an Dublin Bay virtually lapped the roadside; the 13~11 undraped maiden reclining upon clouds was Wall led to exciting waters and dunes; for an removed when the Jesuits took over the building outing there was Howth with its picturesque in 1841, presumably lest the eyes of their schoolboy fishing harbour, or the seaside resort of Portmar- charges be directed heavenwards a little too nock; there was the thrill of a boat trip to Lambay constantly. Bronze medallions with an Apollo Island with its birds and breathtaking scenery, and motif decorate the staricase handrails, and the the Dublin and \Vicklow mountains overlooking nossi fireplace in the chapel calls to mind an age the city and its bay were within easy reach for a that devoted more time and money (Belvedere family picnic. On dull winter afternoons Dublin practically beggared himself in building the house) children flocked to the pictures in frenzied excite- to aesthetic rather than functional considerations. ment. There was such a selection of marvellous The chapel of Belvedere was, as in the other major cinemas in those days-"The Lux" (De-Luxe), Catholic schools, the nidus of spiritual instruction "The Tivo" ('Tivoli), The Pillar, The Grand and development, as one named James Joyce who Central, The New Electric, The Grafton, and The had sat there 25 years before Walter has recorded Cameo. These cinemas were more like community in pungent tones-"The chapel was flooded by the centres than mere picture houses. The discerning dull scarlet light that filtered through the lowered and very talkative young audience had their own blinds; and through the fissure between the last sin~pleway of categorising the characters of the blind and the sash a shaft of wan light entered like screen be they of the western (by far the most a spear and touclled the embossed brasses of the popular), romantic, or classical genre. The hero candlesticks upon the alter that gleamed like the was known as "The Fella" and his girlfriend was battle-worn mail armour of angles". Joyce found "The Mot"; "The Fella" invariably had a "Pal", even less favour with his Jesuitical mentors than an accomplished horse or dog which could with with Ireland's censors, and his early writings consummate skill extricate him and his "Mot" would not, we can take it, have been a topic for from the machinations of the "Head Crook" and discussion in Belvedere during Walter's schooldays. his unsavoury "Mot". It would not have been long, however, before At the age of 11 Walter was sent to the Jesuit Walter's literary curiosity drew him to compare School, Belvedere College. Situated a stone's notes with his (now) distinguished literary pre- throw from O'Connell Street, Belevedere was and decessor. What, we can only ask ourselves, would still is one of Ireland's leading Catholic schools. he have tllought of Joyce's vivid description of the From an imposing Georgian five-bay mansion sermon on hell which was to send Stephen generations of schoolboys have gazed over the Daedalus reeling from the college chapel-"Every rooftops of the city towards the Liffey to where sense of the flesh is tortured and every faculty of the Custom House dome rises. Belvedere House the soul therewith; the eyes with impenetrable 5 utter darkness, the nose with noisome odours, the failed in his ambition to establish a first class ears with yells and howls and execrations, the taste department of medicine, and indeed were he to with foul matter, leprous corruption, na~neless return today his words of 1930 would be no less suflocating filth, the touch with redhot goads and prescient-"No money seems to be available for spikes, with cruel tongues of flame . ." clinical research in this country today, and indeed, Walter's time at Belvedere was by all accounts little interest, alas, is displayed in it by public happy. He did what was asked of him academically, bodies or private philanthropists". Unpopular with but he was not, it would seem, motivated to excel. many of his colleagues he did achieve a probably We find special mention of him in i"11e Belvederinn unique distinction when resigning from St. of 1930 when he was a member of a debating Michael's Hospital in a fit of pique; the honorary group. Was it here that he began to develop those secretary of the medical board was requested to skills that were later to so impress medical audi- recommend the acceptance of his resignation and ences? He indulged in sport as required, and to express to Dr Moore the board's pleasure in so though not an overenthusiastic participant, he doing. cleveloped a keen interest in rugby and cricket. Walter's class included many talented students, At Belvedere some of the characteristics that one of the brightest being Gerald Fitzgerald with formed the man to whom this volume is dedicated whom Walter was very close. In 1935 Gerald were moulded and developed, but there were other liitzgerald was awarded the Gold Medal of the inlluences. Even at this distance in time we can Medical Society and in the following year the detect the warmth of the Clontarr home where at award was made to Walter Somerville for his an early age Walter was directed towards music paper on "Histidine and gastric disorders". Both which was to be his abiding interest until medicine students graduated MB BCh BAO NUI, on 6 July later took precedence. A talented musician Pro- 1937. The friendship was brought to a sad close fessor Jarlett Smith was engaged by Walter's with the death of Gerald Fitzgerald a few years parents to teach the children to play the piano, and ' later. Ire was a regular caller to Clontarf over many years. Walter was appointed house physician to the Under his tuition Walter became quite an accom- Mater Hospital then the largest hospital in Ireland plished pianist, but perhaps more important with 412 beds. The resident doctor of the thirties Professor Smith, a man of broad ci~lturalinterest, in Dublin worked hard in the mornings and when developed his pupil's aesthetic sensibilities.