Professor John Douglas Swales, MD, FRCP
This communication records the immense contribution made by John Swales to clinical science and the practice of medicine, most notably in the field of hypertension. In September 2000, John suffered a cardiac arrest while browsing the local bookshop on the University of Leicester campus. He was resuscitated by colleagues but died 2 weeks later without regaining consciousness.
It was a tragic, sudden, and premature end to a glorious career. John Swales was born in Leicester in 1935 and was educated at the local grammar school. His intellectual abilities were recognized early when he was awarded a major scholarship to study medicine at the University of Cambridge, from which he graduated with first class honors and the University prize. He completed his undergraduate medical education at Westminster hospital medical school, University of London, before embarking on a distinguished postgraduate medical career in London and Manchester, where Sir Douglas Black was his mentor. In 1974, he was invited to become the Foundation Professor and Chairman of Medicine at the new medical school at the University of Leicester. It was a daunting challenge, to build an academic department of medicine from scratch, and one that John could readily have avoided by accepting one of the many comfortable established positions on offer elsewhere. That was not his style, and with relish, John accepted the challenge to help build a medical school in his hometown at Leicester. He served as Chairman of Medicine from 1974 until 1996, and during that time, he guided his fledgling department from humble beginnings to one that became internationally respected, particularly in his beloved field of hypertension.
Among his many professional contributions, John was editor of Clinical Science (1980 to 1982), the founding editor of the Journal of Hypertension (1982 to 1987), and editor of the Journal of the Royal Society of Medicine (1994), as well as a serving member on the editorial boards of these and many other journals, including Hypertension and the Lancet. He was also editor of the Textbook of Hypertension, one of the most authoritative texts on the subject. He was widely sought to debate on many issues related to hypertension, notably and entertainingly on the role of salt. He served on the scientific council of the International Society of Hypertension and was a fellow of the American Council for High Blood Pressure Research and an honorary fellow of the Australian Blood Pressure Council. He helped form the British Hypertension Society and served as its second president.
John was a complex and cultured man, with many interests beyond medicine. His great passion was classic literature, and he was justifiably a respected authority on antiquarian books. His literary skills combined with the breadth and depth of his knowledge in hypertension formed an unusual but glorious marriage. He wrote carefully and beautifully. The clarity and economy of his scientific prose was refreshing and enlightening. His many contributions to the scientific literature are a testimony to these qualities. At the podium, he was a star. He was a master of his brief, and formidable but courteous in debate. His lectures were always engaging, incisive, and laced with irony and humor; he was a magnificent speaker. In many ways, his analytical skills and his ability to communicate his thoughts with clarity defined him. His contribution to the clinical science of hypertension was not so much marked by any one piece of work but more by his thinking and the rigour and integrity of his analysis. He was an original thought-leader. His appraisal of data, whether fresh from the laboratory or published work, was clever and definitive. In this regard, he was a brilliant journal editor, thorough manuscript and grant reviewer, and a much sought-after chairman. He held the view that so much of what we needed to know was already known and recorded in his beloved libraries. That, all too often in science, there was an urgency to move on before the implications of previous work and published data had been fully evaluated. That time spent in the library reading original articles, a process of “re-searching” in the true sense of the word, was more informative and more powerful than the latest gimmick or technique of the week. These principles were the basis of his ethos for mentoring and training scientists and clinicians. He firmly believed that good medical practice should be founded on a strong scientific understanding. We all worked with John at Leicester, and it is no coincidence that his enthusiasm for hypertension and his approach have rubbed off on us all.
Many readers of this piece will have known him as a scientific colleague and will have admired him as such. Fewer would have been aware of his aforementioned passion for classical literature. Fewer still would have recognized his strong interest in Russia, its leaders, its culture, and the Russian Orthodox Church. Despite the latter, he was not a religious man. Perhaps he was too sceptical and too analytical to be religious. He was, however, a private and spiritual man, who was moved and inspired by the written word. He moved effortlessly and comfortably between the scientific arena into his cultured life outside medicine. His family was similarly protected from his academic life, although he talked often of his wife, Dooney; his son, Philip (a doctor in Leicester); and his daughter, Charlotte (a chartered accountant in London). For those who did not know John at all, they no doubt viewed him as an imposing, serious, and cultured man. He could be all of those, but more often, he was very engaging and an entertaining raconteur with a wicked sense of humor. He was also very supportive of his colleagues and friends in a typically discrete way.
In 1996, John surprised us all when he accepted the invitation to become National Director of the National Health Service Research and Development Program (R&D) in London. He had the vision that he could energize the research ethos of one of the largest state healthcare programs in the world. However, to his credit, John was no politician. The frustrations of being a master to political expediency and correctness were palpable. John quickly realized that his exciting and ambitious vision of R&D was very different from that of politicians. He retired after 3 years in the post and returned to Leicester as emeritus professor of medicine. It was to be a golden era in John’s life. He was visibly more relaxed and content. Unburdened by any administrative responsibility, he lectured and wrote prolifically. He astonished us all by taking family holidays! He was looking forward to a very happy and productive phase in his life, and his ever-present willingness to discuss research was enhanced by the unaccustomed commodity of time. How tragic that this should end so abruptly.
Hypertension has lost a great ambassador. A man who was involved in, or at the forefront of, so many key clinical and scientific developments in this field over 3 decades. Those of us who worked closely with him will miss his wisdom, subtle wit, and scientific companionship. To those who only knew of him, read his written work to appreciate a master of his craft.