John Walls (1939–2001): An Appreciation

The Department of Nephrology, Leicester General Hospital

John Walls, one of the leading figures in British nephrology, died on 1 March 2001; he was only 61 years old. Nephrologists in Europe and beyond mourn his passing, but especially in Leicester we are greatly saddened at the loss. At his death he remained clinical director of the nephrology service he had founded in Leicester, as well as academic head of the division of nephrology.

John Walls studied medicine at Leeds University, graduating in 1963. His initial nephrology training took place in Newcastle-upon-Tyne, under the supervision of Professor David Kerr. He was awarded an American Medical Association Distinguished Scholarship in 1971 and spent 2 years at Washington University School of Medicine, St Louis, Missouri working with Dr Neil Bricker. During this time he was co-director of the Chromalloy-American Kidney Center and Assistant Professor of Medicine. In 1973 he returned to the UK and took up a lecturer's position in Newcastle until he was appointed as consultant nephrologist in Leicester in 1974.

For 14 years he worked as a single-handed consultant nephrologist in Leicester, and through his remarkable drive and enthusiasm was able to establish what is now one of the largest renal units in the UK with an internationally recognized clinical, teaching and academic reputation. The first stage of his work was to develop a nephrology service from almost nothing. When he arrived his resources comprised only two in-patient beds and no dialysis facilities; within a decade he had established a full dialysis and nephrology service for a population of 2 million people. His success was achieved through a clear, single-minded vision based on his commitment to patients. When clinical colleagues and administrators did not share his vision he was an unrelenting and skilful negotiator always adept at securing the resources he needed. John set the most meticulous standards of clinical care. He had a remarkable memory for the problems and concerns of individual patients and their families; an attribute which earned their respect and admiration. His passion for his clinical and administrative duties in Leicester inspired many junior doctors to pursue a career in nephrology. The number of nephrologists who now hold senior positions in renal units in Leicester, in other parts of the UK, and elsewhere in the world is testament to his influence.

The creation of a clinical service on that scale would be achievement enough for many people, but as it was becoming established, John set out to develop alongside it an academic division of nephrology. His own interest in the metabolism of uraemia led on to work on metabolic acidosis which established his international reputation along with continuing research in many aspects of clinical nephrology and dialysis. He published over 180 original articles as well as contributing to numerous textbooks on nephrology. He recruited clinicians and scientists whose research interests and expertise complemented his own to build a strong and broad-based division. He convinced many to pursue a research career and was a loyal and inspiring mentor. Fellows from many parts of the world came to spend a year or two in the division and left not only with a successful stream of research established but grateful they had enjoyed the camaraderie and energy that John had instilled, taking away lasting professional contacts and friendships. In recognition of his clinical and academic achievements John was made Professor of Nephrology in the University of Leicester in 1990.

He made an increasing contribution to the wider work of the nephrology community in the UK. He was a vigorous and innovative president of the Renal Association from 1995–1998, and oversaw preparations for the 50th anniversary celebrations of that association (the oldest nephrology society in the world). It was a special sadness that he could not join his friends and colleagues at that anniversary occasion in Cambridge in 2000. His work received international recognition: he was awarded an International Distinguished Medal by the American National Kidney Foundation in 1998 and was the current president of the International Society of Nutrition and Metabolism in Renal Disease.

John's professional contribution went far beyond nephrology. He was appointed in Leicester just as a new medical school was being established there and he gave much to its development particularly with periods as clinical sub-dean, responsible for clinical training of medical students, and postgraduate dean, responsible for postgraduate education of all trainee medical staff. Most recently he had been elected clinical vice-president of the Royal College of Physicians of London.

The extraordinary energy and drive with which John approached all aspects of his professional work were paralleled in other parts of his life. He played squash with great vigour into middle age, and running was a constant enthusiasm. He ran eleven marathons around the world, and in 1986 ran the London Marathon in the remarkable time for a veteran of 2 h 58 min.

We, his professional friends and colleagues in the department he founded and nurtured, especially mourn his passing. To his wife, Adele, and sons, Mark and Simon, we extend our deep sympathy.

The breadth of his work was remarkable, but it is, above all, his achievement in creating from nothing the Leicester unit which we respect. We carry his legacy forward determined that it should grow as he would have wished. We have lost a fine role model—as clinician, teacher, scholar and leader; we shall miss him.





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