Ivan Barry Pless
Montreal, Canada (Summer 2013)
In 1964 I arrived in London to start a two-and-a-half year fellowship in “Social Pediatrics,” as it was called at the time. A few years earlier, Dr. Bob Haggerty—the undisputed leader in this field—had used some of his Markle Scholarship funds to visit most social medicine units in the United Kingdom and Europe. Haggerty kept detailed notes describing these units and kindly shared this “medicalogue” with me, his protégé. It served as my travel guide when I figuratively (and, at times, literally) followed in his footsteps.
In London, one name was familiar even to a novice like me. Ronald (Ronnie) Mac Keith was a pediatrician and author of many articles and a classic book on breastfeeding, but he was perhaps best known as the editor of the journal Developmental Medicine and Child Neurology. He was responsible for the Wolfson Centre at Guy’s Hospital (what today would be called a “developmental clinic”). I chose it because at the time it was in the vanguard of social pediatrics. Ronnie and I also shared an interest in the care of handicapped children—although years later we often disagreed about the meaning of the term developmental pediatrics, among other things.
When I first met him at Guy’s, I was greeted by a short, bespectacled, dapper man, with a red carnation in his lapel. I later discovered that the carnation achieved emblematic status and there were many theories about why it had become his symbol. One of his pediatric colleagues, John Apley, had this to say about the flower:
The carnation is a badge. There are more fanciful . . . explanations, but he once admitted to me that . . . in his early days, he took to wearing a carnation . . . because this gave him courage and poise before an audience . . . Gradually, the carnation became the badge of the Little Club, so named after Dr. W.J. Little, who studied causes of cerebral palsy a hundred years ago. . . . Now, as a flower, or a tie or cravat, it is a badge carried by colleagues who have joined Ronnie in caring for handicapped children . . . .1
After introductions and a quick tour of the Wolfson Centre, Ronnie invited me to his club for dinner. That club was none other than the Athenaeum on Pall Mall. I was told at the time it was the more or less exclusive haunt of writers and artists, although I later discovered this was not entirely true. The website explains:
The club was founded as a meeting place for men who enjoy the life of the mind. Over the years the membership criteria have been widened and now extend to persons of attainment or promise in any field of an intellectual or artistic nature and of substantial value to the community. Today many of the Members of the Athenaeum, indeed a majority, are professionals concerned with science, engineering or medicine . . . .2
The meal was sensational, but it was the surroundings that overwhelmed me. I was well out of my depth, yet Ronnie just carried on as if I were Samuel Johnson or a life-long member. Actually, Dr. Johnson preceded the founding of the Athenaeum by almost a century, but an account on the Club’s website of two equally famous successors is too moving to omit:
There are many stories—one on record describes the reconciliation at the foot of the stairs in 1863 between Dickens and Thackeray, who had not spoken to each other for years, after a famous quarrel. Thackeray, although only 52 was clearly a dying man. Dickens, seeing him slowly descending into the hallway, stepped forward, offered his hand and here in the hall made up a quarrel of some twelve years’ duration so that Thackeray could die at peace with the man who had once been his close friend.2
Elizabeth Mac Keith
Courtesy of Andrew Mac Keith
Two weeks after the Athaneum visit, my wife and I were invited to dinner at which time we first met Ronnie’s wife, Elizabeth. This marked the beginning of a 48-year friendship, precious beyond words. We often dined with the Mac Keiths, and for many years after Ronnie’s death we were house guests in their unheated home in Chelsea. Beginning during my fellowship period and on subsequent sabbaticals, Ronnie also invited me to his famous (some might say, infamous) international meetings in Oxford, which he organized and chaired. Most were sponsored by what was then called the Spastics Society, a UK-based charity focused on helping disabled people and their families; others were meetings of the Medical Association for the Prevention of War (MAPW).
Several elements made these meetings distinctive. To begin with, they were held in the awesome surroundings of St. Edmunds Hall, even though Ronnie was a graduate of Queens College. The Oxford meetings were memorable (to the extent that one can remember properly after so much exceptional wine followed by fine sherry—or was it port?) because Ronnie’s invitees were an international collection of distinguished pediatric neurologists, developmental pediatricians, and other physicians of note. The erudite (and often arcane) papers were simply a bonus because the real attraction was the food, wine, camaraderie, and, above all, the scholarly bonds built.3 I suspect that Ronnie had intuited that this was the secret behind successful conferences: not the papers, but the personal and professional relationships that were formed and that so often endured.
Ronnie’s eccentricities were legion. The Spastics Society meetings were relatively tame occasions compared with some meetings of the MAPW, which he chaired. Here is an example: One evening after dinner at the Mac Keith home (in their tiny, but cozy, basement dining room), Ronnie invited me to a MAPW meeting to be held in Oxford. We had just acquired a car, and I offered to drive. After picking him up, and a much-too-leisurely breakfast, he suddenly remembered that he had promised to take another visitor to the meeting. We detoured to a street corner in North London where a clearly hungover, miserable-looking gentleman stood. He got in the car, we were introduced, and he promptly fell deeply asleep. The detour resulted in our late arrival at the meeting. We entered the conference room just as someone presented a paper explaining why there would be no wars if the military consisted exclusively of women. Our passenger, a Russian pediatrician, then approached me during the coffee break that followed and, in heavily accented English, asked, “Please, sir, vere am I and vy am I here?” I told him that we were in Oxford at a meeting of the MAPW, but, I added, I did not know how it was that he came to join us. He thought for a bit and then replied, “Ah yes. I remember. Dr. Mac Keith, he came to me after his lecture and the good dinner last night and asked, ‘Are you against war?’ I said ‘Yes, of course.’ And he said, ‘Good. I will pick you up in front of your hotel tomorrow morning at 8 am.’” He reflected a bit and then asked, “Please. Which way the train to London?” He left.
This is but one recollection among a host of memories, all good and many equally amusing. After his death in 1977 (on my birthday) we remained close to the remarkable Elizabeth who died last year at age 103. A physiotherapist by training and the mother of three children (one of whom died mountaineering in Alaska), Elizabeth was highly intelligent, exceptionally generous, and unbelievably hospitable. She was also a gifted musician who played the cello and continued to attend quartet rehearsals, carrying her cello on the Underground, until she had a small stroke at age 95. Elizabeth was a tireless supporter of the United Nations Association (UNA), among several other good causes. I tried to match her endurance when, on many visits, we spent the day at Tube stations selling “tags” to raise money for UNA. Her hospitality was legendary, as was the collection of friends and near strangers who came to visit—often to stay as uninvited houseguests for longish periods. (Incidentally, one of Ronnie’s bad habits was bringing guests for dinner without troubling to inform Elizabeth in advance!).4
In 1967 the time came for my family and me to return to North America. Haggerty had offered me an appointment at the University of Rochester where he was chair of pediatrics, and I eagerly accepted. By then we had two children but little cash. Accordingly, the return trip was by sea from Portsmouth to New York on the SS France. We packed our worldly goods into three or four trunks and shipped them to the port. That only left us with what seemed like 20 pieces of hand luggage and two children to transport on the boat train to the docks. Then, the night before we left, Ronnie rang and insisted we come by for a farewell drink. We drove to Chelsea, had a drink or two, and as we were leaving, he presented us with a special gift: a case of port!
Ronald Mac Keith with children, Frontspiece, Care of the Handicapped Child, A Festschrift for Ronald Mac Keith, 1-9. Clinics in Developmental Medicine, No.69. London: W. Heinemann.
We were overwhelmed, but not just because it was such a kind and generous gesture. It was also so typical of the whimsical, impractical Ronnie. Evidently he had given no thought to the logistics of getting a case of spirits as well as all the hand luggage and children from Putney, where we lived, to the train and thence to the ship. So we protested, but he was insistent; eventually we compromised and only accepted one symbolic bottle of what I later learned was very expensive port. However, when we returned home we reluctantly decided we could not manage even that one bottle and we left it in London with my in-laws for safekeeping. Some years passed and on a later sabbatical we remembered the treasured bottle and went to claim it. Somehow over time my in-laws forgot it was ours and drank it on their wedding anniversary. Cheers, Florrie and Charles! We never told Ronnie what happened, but we did share the story with Elizabeth who thought it was hilarious. We all agreed it was a “typical” Ronnie gift.
This amusing anecdote describes the fate of one case, and thence one bottle, of port. But make no mistake; Ronnie’s greatest gift was not a bottle of spirits or an amusing memory but his enormous contribution to the care of handicapped children and, I might add, to medical editing. There has been much debate about whether he was actually the father or founder of child neurology (and it would be paradoxical if it was decided he was the founder because he was not a neurologist); however, there is no debate about what he did for the field through his many writings as well as the journal he founded and edited for so long—what is now the “Mac Keith Press.” And, of course, through organizing and hosting those famous Oxford meetings where the key players of the time were brought together to advance the well-being of handicapped children.
- John Apley, “Ronald Charles Mac Keith”, in Care of the Handicapped Child. A Festschrift for Ronald Mac Keith, Clinics in Developmental Medicine, No.69. London: W. Heinemann, 1978. 1-9.
- “The Athaneum Club, Pall Mall, London.” last visited February 16, 2013 http://www.athenaeumclub.co.uk/
- Neil Gordon, “Ronald Mac Keith”, in The Founders of Child Neurology. ed. S. Ashwal. San Francisco: Norman Publishing, 1990. (A division of Jeremy Norman & Company, Inc.) 787-791.
- Martin Bax “Ronald Charles Mac Keith. A personal memoir.” Dev Med Child Neurol 20: (1978) 3–7.
IVAN BARRY PLESS, CM, MD, DSc (Hon), FRCP©, FRCPCH (Hon), FCAHS graduated from Western University (Meds 58), completed his residency at McGill, and held fellowships in US and UK. He was professor at the University of Rochester (1967-75) and McGill (1975-2010), where he has since retired, professor emeritus. His research encompassed care of children with chronic disorders and prevention of injuries. He was a British Council Scholar, a Milbank Faculty Fellow, and a fellow of U.S. Health Services Research. Other honors and positions include the National Health Scientist Award (1976-1997), director of clinical research at the Montreal Children’s Hospital (1996-2008), president of the Ambulatory Pediatric Association (1976), APA Armstrong Award and Research Award, and founder of Canada’s injury surveillance system. He is member of the Canadian Institute for Advanced Research, chair of the Canadian Institute of the Child Health, co-founder of Safe Kids Canada, and member of the MADD Canada National Board. He has written over 182 peer reviewed publications, 60+ book chapters, and 7 books. He is the founding editor of Injury Prevention. Awards include the Order of Canada, Ross Award, Prix Bombardier, ICEHS International Distinguished Career, and Chercheur Emerite. He received an honorary doctorate of science from Western University in 2012.