Hektoen International

A Journal of Medical Humanities

Walter Russell Brain DM FRCP FRS (1895–1966)

JMS Pearce 
East Yorks, England

Lord Brain. From The Royal London Hospital. Source

Russell Brain (Fig 1) was born at Clovelly, Denmark Road, Reading, on 23 October 1895, the only son of Walter John Brain, solicitor, and his wife, Edith Alice. A quiet, reserved man of enormous intellect and integrity, he was revered as an eminent neurologist, philosopher, and author.

At Mill Hill School he studied classics, since his parents wished a career for him in law. He, however, wanted to study science, but his parents did not allow this. In 1914 he entered New College, Oxford to read history, which he disliked. Disapproving strongly of war, he joined the Friends’ Ambulance Unit in 1915 and was sent to work in York. After the war, in 1919, he returned to read Medicine at New College, where JBS Haldane, CS Sherrington, Julian Huxley, and HC Bazett were some of his teachers, and he also met William Osler. Anxious to qualify and get married, he took a shortened course for the BA (1919) and obtained the Theodore Williams Scholarship in physiology (1920).

He moved to the King George Hospital, London, where in the X-ray department he met Stella, daughter of the physician Reginald Langdon Langdon-Down. They married in September 1920. He entered the London Hospital in October 1920, graduated BM BCh (Oxon) in 1922, proceeded DM in 1925, and was elected FRCP in 1931.

Brain joined the medical unit at the London Hospital.1 Under the influence of the Quaker Sir Henry Head and George Riddoch he took up neurology. He was appointed physician to Maida Vale Hospital for Nervous Diseases in 1925, assistant physician to the London Hospital in 1927, and physician to Moorfields Hospital. He was never on the staff of the National Hospital for Nervous Disease at Queen Square.

He made many outstanding contributions to clinical neurology.2 With the gifted if eccentric surgeon Dickson Wright and Marcia Wilkinson, he showed that the median nerve could be compressed at the wrist in the carpal tunnel; surgical relief of this would restore function.3 With D. W. C. Northfield and Marcia Wilkinson he demonstrated the importance of protrusion of the intervertebral disc in the cervical spine as a cause of root and cord compression with paralysis of the legs; this was named cervical spondylotic myelopathy,4 a common neurological disorder.

In an original concept he described the remote effects of cancer (i.e. not caused by secondary deposits) on the brain and peripheral nerves.5 The British Empire Cancer Campaign therefore established at the London Hospital a unit for the investigation of these carcinomatous neuropathies, which Brain directed until his death.

Having originally considered making a career in psychiatry, he never lost his interest in the enigmatic disorders of the mind, and particularly the problems of perception. Mind, Perception and Science (1951), the Riddell lectures on The Nature of Experience (1959), The cerebral basis of consciousness (1950), and his book, Speech Disorders (1961), were the outcome. From the time he was elected to the London Hospital, Brain earned his livelihood as a physician in consulting practice, in which he was very successful. His remarkable memory and flair for lucid yet succinct prose, resulted in Diseases of the Nervous System, first published in 1933 and, unusual for a one-author medical textbook, it reached a sixth edition in 1962 (under JN Walton, then Michael Donaghy, the 12th edition was published in 2012). It was almost compulsory reading for postgraduates in neurology and candidates for the MRCP.

More discursive books were to follow, elegantly written, bearing a subtly reflective quality: Some Reflections on Genius, and other Essays (1960), Doctors Past and Present (1964), Science and Man (1966), Tea with Walter de la Mare (1957), and Poems and Verses (1961). He edited the premier neurological journal Brain from 1954 till his death. Lord Brain’s remarkable career culminated in his being elected President of the British Association for the Advancement of Science, the first practicing physician or surgeon to hold that office since Lord Lister.

He was a supremely astute clinician who, for example, predicted the nature of the inheritance in familial goiter in 1927. It was his clinical case reports, his interests in the brain-mind problem, the nature of consciousness, and the subtle aberrations of speech and perception which gave rise to his philosophical writings. In the seven years (1950-1957) when President of the Royal College of Physicians, he published thirty papers and two editions of his textbook, and sat on two Royal Commissions. At the same time in 1957, he published Tea with Walter de la Mare (cited as a Medical Classic in a 2008 issue of the BMJ). He achieved all this, supported by a clinical practice, an ease of writing, two secretaries, and the royalties from his successful textbooks. All his work was characterized by precision, great industry, and the refusal to waste a minute, so that he even dictated and read when traveling in the back of his car.

I remember Lord Brain as an impressive, shy, quiet, but kindly man of great learning. His lack of small talk was disconcerting, and his silences could be disturbing. Yet his well-prepared and self-rehearsed public speeches, addresses, and orations were disarmingly spontaneous, erudite, and witty.6 He once wrote:

“There are two international languages of religion: the Latin of the Roman Catholic Church, and the silence of the Quakers.”

Russell Brain and Stella Langdon-Downi had two sons and a daughter, to whom they were devoted. They joined the Society of Friends in 1931 and regularly attended the meeting house on Sundays. He gave the Swarthmore lecture in 1944, Man, Society and Religion, in which he stressed the importance of a social conscience. This conscience of his led him to become chairman of the medical council of the London Hospital during the war, defending the interests of those away on active service. He became a member of King Edward’s Hospital Fund for London and chairman of its hospital service plan. He attended Winston Churchill as a patient on twenty occasions.6 In 1950 he was elected President of the Royal College of Physicians, London, retaining this office until 1957. He was a member of the Royal Commission on Marriage and Divorce in 1952, of the Royal Commission on Mental Certification and Detention in 1954, and of the Interdepartmental Committee on Drug Addiction in 1958. He became President of the British Association for the Advancement of Science in 1963–4.

He was knighted in 1952, created a baronet in 1954, and made Baron Brain of Eynsham in 1962. He was elected FRS in 19647 and an honorary Fellow of New College, Oxford in 1952. He received honorary degrees from many universities and was an honorary member of American and European neurological societies. He gave the Linacre lectures at Cambridge, the Riddell lectures at Durham, the Bryce lecture at Oxford, and the Osler oration in Canada. He was awarded the Osler medal for 1960 at Oxford.

A modest man, he combined the skills of the clinical scientist with those of the literary man, philosopher, and politician. Sir George Pickering described him as a medical statesman of wisdom, insight, and stature. Henry Miller, that most erudite, witty neurologist, reviewing Brain’s Doctors Past and Present admirably summarized the man:

A mind remarkably at home among the literature and philosophy of to-day and yesterday as well as with every aspect of contemporary medicine and science, a mind furthermore in which judgments of men and affairs are so balanced, so humane, and so eminently reasonable that one looks in vain and—let us admit it, even with a faint sense of disappointment—for some comforting hint of the kind of prejudice or irrationality which so often colors our own most firmly held opinions.

He died of prostate cancer at his home, Hillmorton, Coombe Hill Road, Kingston, Surrey, on 29 December 1966, working to the end: his last working day was devoted to arranging a new issue of Brain. A meeting in his memory was held at Friends’ House, London, on 10 February 1967.

He was succeeded to the baronetcy by his elder son, Christopher Langdon (b. 1926). His younger son, Michael, who attended Leighton Park School, became Professor of Haematology at McMaster University, Ontario.

This account is based on Pearce JMS. Walter Russell Brain, In: Quakers in Medicine, ‘Friends of the Truth’, Sessions of York Ebor Press 2009. pp. 92-97

Endnote

  1. Granddaughter of John Langdon Haydon-Down (1828 – 1896), after whom Mongolism or Down’s syndrome was named

 

References

  1. Howie J. Portraits from Memory 17. — Sir Walter Russell Brain, FRS, PRCP (later Lord Brain) British Medical Journal 1987;295:108-9.
  2. Royal College of Physicians Archives: Walter Russell Brain (1895-1966), 1st Baron Brain of Eynsham: personal and professional papers 1907-66 MSS 3133-3296
  3. Brain WR, Wright AD, Wilkinson M: Spontaneous compression of both median nerves in the carpal tunnel. Lancet 1947;1:277-282
  4. Brain, WR, Northfield, DWC, Wilkinson, M. Neurological manifestations of cervical spondylosis. Brain 1952;75:187
  5. Brain, WR , Henson, RA . Neurological syndromes associated with carcinoma – carcinomatous neuropathy. Lancet 1958;2:971–4
  6. Brain MC. In: W. Russell Brain, “Encounters with Winston Churchill,” Medical History, vol. 44, 2000, 3-20.
  7. Pickering, G. W. Biography: Brain, W. Russell, 1895-1966. In: Biographical memoirs of Fellows of the Royal Society, vol. 14, November 1968

JMS PEARCE, MD, FRCP, is a retired neurologist and author with a particular interest in the history of science and medicine and emeritus consultant neurologist in the Department of Neurology, Hull Royal Infirmary.

Fall 2020

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