Dr Thurstan Brewin

Obituaries - Clinical oncology
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Dr Thurstan Brewin

20/12/1921 to 25/02/2001
Memoir Author: 
Gareth Rees

Thurstan wrote his first medical article, on how to perform a tonsillectomy, at the age of 8. Later he became a boarder at Rugby School. As a twenty year old officer he was injured in North Africa in 1942 and had to have his left leg amputated in an Italian Hospital. Here he ran the prisoner's library and acquired a reputation for his great knowledge of books and for his ability to carry large numbers of them whilst walking with crutches. He returned to England in 1943 and started as a medical student at Guy's Hospital. He qualified in 1949. As a houseman he and his fellow houseman George Scott were famed for their high speed descent of five flights of stairs - Thurstan hopping. Thurstan's boss Sir Rowan Boland had lost an eye in the First World War. A former merchant seaman with paranoid delusions thought he was being pursued by pirates when confronted by the two doctors, one with a black eye patch and the other a wooden leg. 'Let's do this properly,' said Boland, 'on the next ward round I'll have a parrot on my shoulder'. Thurstan loved meeting people from all walks of life and he had a great sense of fun. After house jobs Thurstan did medical and radiotherapy registrar jobs at Guy's and the Westminster respectively and then spent five years at the Ontario Cancer Foundation. He became a consultant at the Institute of Radiotherapy and Oncology in Glasgow in 1961. Later in his career he was Deputy Director for some years, becoming Director in 1985. The voluminous highly detailed notes and copied letters he kept concerning vast numbers of his patients is a testimony to his care and commitment towards achieving the best for them, and to both the academic and personal interest he had in them. He served two three-year spells on the Council of The Royal College of Radiologists, organized the twice yearly weekend radiotherapy and oncology courses for some years and was a final fellowship examiner. Among several other commitments he served also as President of the Scottish Radiological Society, Editor of the Bulletin of the Royal College of Physicians and Surgeons of Glasgow. Every New Year's day for 18 years he was goalkeeper for the evens team in the odds versus evens match involving neighbours from the road in Glasgow where the Brewins lived.

Thurstan's adored wife Doreen died in 1986 - they had met as teenagers. Thurstan retired the following year, when he became Medical Director of the Marie Curie Foundation for three years. Subsequently he became a Member of Council of the Sue Ryder Foundation and Chairman of HealthWatch. The latter reflected Thurstan's concern about what he saw as a growing belief in magic in society, and the apparent abandonment of the need for evidence of efficacy evident in the blurring of boundaries between mainstream and fringe medicine. A longstanding member of the 1951 Radiotherapy Club, he remained an enthusiastic and active participant throughout his retirement.

At Glasgow Thurstan became fascinated by alcohol intolerance and altered taste in cancer patients. He conducted extensive clinical research involving systematic detailed questioning of thousands of patients. He demonstrated that several types of alcohol intolerance, pain included, are more common than had been (and still often are) recognised. He demonstrated also that women with cancer sometimes experience the same appetite and taste alterations they had had years earlier when pregnant. Later he wrote many other articles on a wide variety of subjects, but which were concerned in particular with the philosophy of clinical management, relationships betweeen patients and their relatives and doctors, ethics, consent, clinical trials and fringe medicine. He acquired a national and international reputation for these thought-provoking and well- written contributions, in which logic and common sense are consistent ingredients. A selection of his writings was published as 'The Friendly Professional' in 1995.

Thurstan would argue eloquently that some paternalism suits many patients very well. He believed strongly that doctors should demonstrate friendliness in their dealings with their patients and be interested in them as individuals, and that patients do not become less interesting just because the prognosis is bad. Another strong belief was in the great value of sensitively used humour as a clinical tool. He was committed to randomized clinical trials. He was joint editor of the textbook Cancer in the Elderly published in 1990 and published the very well reviewed Relating to the Relatives, dealing with breaking bad news, communication and support, in 1996. His last publication was just 6 weeks before his death - 'Deserted' - a BMJ personal view which was a plea for more doctors to realise the importance of regular and frequent visits to those with advanced or terminal disease.

Political correctness mattered little to Thurstan, and he disliked dogmatism. In a 1999 Lancet book review he said he did not much care for slogans but if he had to coin one it would probably be 'People and pragmatism before principles'. He leaves five children and 13 grandchildren.