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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.56 n.4 São Paulo Dec. 1998

http://dx.doi.org/10.1590/S0004-282X1998000500035 

IN MEMORIAM

 

 

Ascetic yet charismatic, tall and always impeccably dressed Critchley cast an imposing and elegant figure on his visit to the bedside of the neurologically sick at the National Hospital for Nervous Diseases, Queen Square, London.

The son of a humble clerk at the Bristol Gas Works he was educated at the Christian Brothers College and gained a place at the University of Bristol at 15. Deemed too young to take it up, he taught himself ancient Greek at home and then studied Russian. His determined plans to join the Imperial Russian Army were, however, thwarted by the Bolshevik Revolution. His medical studies were interrupted by a chequered stint in the Wiltshire Military Regiment. Court-martialled on a charge of being late on parade he found himself ordered to decapitate and fillet 500 fish, a factor he later claimed influenced him to avoid becoming a surgeon. A second charge of going missing, led to a punishment of intensive gardening. He never gardened again! On resuming his medical career ha graduated with first class honours at the age of 21 years, was appointed to the staff of the National Hospital for Nervous Diseases, Maida Vale at 27 and perhaps most remarkably of all became a Fellow of the Royal College of Physicians at only 30.

Domestic honours included, Dean of the Institute of Neurology from 1948-1953, Neurologist to the Royal Navy from 1939-1977, Vice-President of the Royal College of Physicans. His Goulstonian, Harveian, Sherrington, Croonian and Hughlings Jackson lectures were meticulously prepared and captivatingly delivered. He was particularly proud of his appointment as Master of the Worshipful Society of Apothecaries and in 1983 with Princess Margaret he presided at a sumptuous banquet for his many friends from the five continents. He was awarded a Commander of the British Empire but his distinguished contemporaries at Queen Square, Walshe and Symonds both became knights. When asked about his relative lack of honours Critchley stated it was because he had once driven the wrong way up a one way street in Portugal.

His academic achievements were acknowledged internationally by his Presidency of both the World Federation of Neurology and the International League of Epilepsy and in fulfilling his responsabilities in these roles he travelled and lectured all over the world. His interests in neurology were eclectic, although he is probably best remembered for his work on the parietal lobe and his interest in the then unfashionable field of dyslexia which he felt was inherited and if picked up early was amenable to remedial educational therapy. He explored unfashionable by-ways, writing on lightning injuries, the neurology of old age and the effects of boxing on the nervous system. In my own field of abnormal movement disorders he wrote extensively on the different causes of Parkinson's syndrome and particularly reinforced Marie's concepts of arteriosclerotic Parkinson's Syndrome. His lecture on Huntington's chorea which I was fortunate to hear twice, describing the arrival of the disease on East Coast of the U.S.A. with the Winthrop fleet of the Pilgrim Fathers, was enthralling. Tics and occupational cramps also fascinated him. His writings spanning six decades were so extensive with more than 300 single author papers that after his retirement I recall him browsing through the three box files containing his papers in the medical library at Queen Square and with a puzzled look asking the librarian "Did I really write that?" In neurology the only areas he left relatively unscathed for the next generation of Queen Square neurologists to attack were peripheral nerves and muscle, the latter he considered only good to eat not to study.

His restless mind could not be satisfied solely by neurology and essays such as `Tattooed Women', `Oscar Wilde's Death', Man's Attachement To His Nose', `The Idea Of A Presence', `The Survivors Of Shipwrecks', `Sign Language' and `Musical Timing' can be found in his literary classics `The Black Hole and Other Essays', `The Divine Banquet Of The Brain', `The Citadel Of The Senses', `Music And The Brain' and `Silent Language'.

Critchley will be remembered for his silvery tongue, his elan and awe-inspiring erudition. He never made an unnecessary movement and frequently counselled patients against any form of exercise warning them it could seriously damage their health. His turn of phrase was both lucid and arresting and his prose polished and economical. In private he was relaxed, generous and always helpful and his mischievous wit enlivened many official banquets. His interest in body language led to his close friendship with Marcel Marceau, the French mimic. His Wednesday afternoon and Saturday morning clinical demonstrations at Queen Square were usually packed out and his controlled showmanship embellished his inspired and unforgettable presentations.

Critchley made two visits to Brazil the first in November 1958. He set off by plane from London, docking in Milano, Lisboa and Recife before arriving in Rio, to be met by Drs. Niemeyer and Akerman exactly 24 hours later. The next day he lectured on the Psychology of Pain and later gave talks on Reflex Epilepsy and the Parietal Lobe. In the visitors book at the Neurological Institute in Rio he wrote of its magnificence, its growing reputation in Europe and his impression that lively brains were at work. A week later he was in Sao Paulo and it was after this trip that the first Brazilian neurologists in training began to defect to Queen Square. Three years earlier he had published an article in Arquivos de Neuro-Psiquiatria on a phantom supernumerary limb after a cervical root lesion. Professor Spina-Franca recalls Critchley's impressive teaching style marked by its clarity of thought and in correspondence to me he wrote " .... in brief he inspired me as a master for whom Shakespeare stated `I have what I gave'. ".

In 1980, to celebrate his eightieth birthday, a festschrift was held in London at the Medical Society under the aegis of the World Federation of Neurology. It was a fitting tribute to one of the `grand seigneurs' of the British Neurology and a direct link to the founders, Jackson, Gowers and Ferrier. At that time Critchley was still seeing a few patients and lecturing at Queen Square. In the same year he talked at an International Symposium on Parkinson's Disease about his 60 page article in the 1929 edition of Brain on arteriosclerotic Parkinson's syndrome. He concluded his paper as follows: ` .... in self-defence I will concede that it would have been appropriate to speak of arteriosclerotic pseudo-Parkinsonian but no other disclaimer will I make.'

Five years later I accompanied him and his second wife Eileen to L'Hospital Salpetriere in Paris for the Centenary celebrations of Gilles de la Tourette's description of maladie des tics confulsifs. Although his vision was failing and he was frailer physically his indomitable joie de vivre and resilience were undinted. The journey passed quickly with his gossipy asides and anecdotes of bygone days at the National Hospital.

His final years were spent in his home called Hughlings House in his beloved West Country where he belied Samuel Johnson's aphorism that once a man is tired of London he has tired of life. He continued his correspondence with friends and students using a felt pen and magnifying glass to help his failing sight. Shortly before his death he completed his biography with his wife on John Hughlings Jackson, contesting vehemently the heretical grammatical and spelling changes enforced by his publishers with their commercial eye on the American market. His indefatigable iron will had a dictionary planned as the next project.

Despite the lure of molecular biology and functional imaging Critchley's watchful gaze from his portrait in the Queen Square lecture theatre ensures that the relevance and importance of classical clinical investigation will be preserved by his successors on the staff of the National Hospital. His example is an inspiration rather than a burden, and his maxims will be transmitted by direct leneage to successive generations of students.

He is survived by Eileen his second wife and loyal partner and collaborator, and by two sons Sir Julian, a former Member of Parliament and Nicholas by his first wife Edna.

 

Andrew Lees