(Richard) Michael Mason, MA, DM, FRCP (1917–1977)

Heberden Historical Series/Series Editor: M. I. V. Jayson

C. G. Barnes

Little Hoopern, Chagford, Devon, TG13 8BZ, UK.

Richard Michael Mason (Fig. 1), always known as Michael, was born and brought up in India until he entered Marlborough College and later Christ Church, Oxford and St Bartholomew's Hospital Medical College, London. He qualified BM, BCh in 1942 in the early years of the Second World War. He escaped injury at St Barts during the blitz when a bomb fell through the block where he had his bedroom as he was on the ward at the time. He gained MA (Oxford) in 1943. Having been a pilot in the Oxford University Air Squadron, he then served as medical officer in the RAF with squadrons 604 and 616 in Germany and Denmark and was demobilized with the rank of Flight Lieutenant.



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FIG. 1. (Richard) Michael Mason.

 
On returning to civilian medicine he became medical registrar at St Barts and then turned to rheumatology as chief assistant to Dr W. S. Copeman and Dr Oswald Savage at the West London Hospital. He gained MRCP (1948), DM (Oxford: 1953) and FRCP (1962). His first consultant appointment was in the Department of Physical Medicine at Chase Farm Hospital, Enfield. In 1955 he was appointed consultant in the Department of Physical Medicine at The London Hospital where Dr W. S. (‘Will’) Tegner was the senior consultant. The department at The London Hospital had been formed by Dr (later Sir) Robert Stanton Woods in 1917, initially as the three departments of Massage, Electrotherapy and Remedial Gymnastics, he being the first such consultant in Great Britain. In 1936, Dr Will Tegner, then senior registrar, suggested that Sir Robert, who had always had a deep interest in the rheumatic diseases, should request an allocation of beds. The Medical Council of The London Hospital agreed to an allocation of six beds and it is recorded that these were ‘for the investigation and treatment of the rheumatic diseases’. Thus, although ‘Physical Medicine’ was regarded as a therapeutic specialty, rheumatology had formally arrived at The London through the work of Sir Robert Stanton Woods and Dr Will Tegner, and was then strengthened by the appointment of Michael Mason. The department was subsequently renamed the Department of Physical Medicine and Rheumatology (1964) and then Department of Rheumatology (1970) [1].

Michael Mason was also consultant in rheumatology to Notley Hospital, Braintree where he forged links with the orthopaedic surgeons, to the Royal Masonic Hospital, King Edward VII Hospital for Officers, and to Osborne House, Isle of Wight. He became Civil Consultant to the RAF in 1970, which gave him pleasure and amusement having been a Flight Lieutenant previously, and became a member of the Armed Forces Medical Advisory Board.

Michael was a clinician at heart and his DM thesis (Oxford: 1953) was on the treatment of gout. It was he, in the principal paper arising from his thesis [2], who emphasized the possibility of triggering an attack of gout by starting treatment aimed at lowering the blood uric acid level, probenecid being the drug of choice for interval therapy at the time. This important message was remembered when allopurinol became available. He was always teaching his juniors and the medical students making rheumatology come alive, helped by his patients who were always appreciative of the personal, expert and friendly care he offered and who realized the importance of teaching the next generation of doctors. His clinical acumen was remarkable, resulting from careful history taking and clinical examination at all times, even when under pressure in ever enlarging out-patient clinics. He was constantly in demand for advice on diagnosis and treatment of patients, and on career development by juniors both from The London and elsewhere.

He was involved in the development of clinical trials, in doctor–patient communication studies, and in the early understanding of the seronegative arthropathies. It was he who strongly supported Harry Currey's idea that a formal clinical trial of azathioprine treatment in rheumatoid arthritis should be performed, leading to the first publication of such a trial in 1968 [3]. It was by chance that he became interested in Behçet's Syndrome (BS) when a patient with a curious arthritis was admitted to The London in 1965. That patient remained undiagnosed until a second patient was referred from elsewhere when, in a departmental clinical conference, Will Tegner and Michael Mason asked about mouth and genital ulcers and ‘the penny dropped’. Four patients with BS were identified on whom Michael Mason based his Heberden Round in 1966. He, with Colin Barnes, then set about searching for more patients and published the first British series of 25 patients in 1969 [4] and suggested a scheme of diagnosis based on Hippocratic principles, which became known as the ‘Mason and Barnes criteria’.

With Will Tegner he progressively developed the department at The London. He established a close relationship with orthopaedic colleagues and with them was involved in the development of surgery of the rheumatic diseases, especially of rheumatoid arthritis. A regular hand clinic, first with Oliver Vaughan-Jackson and later with Basil Helal, was one of the early pioneering associations in this field. This all led to the establishment of an Academic Department of Rheumatology at The London Hospital Medical College in 1967 by the creation of the ARC Senior Lectureship in Rheumatology. The first incumbent was Harry Currey, who subsequently was promoted to Reader and Professor with a personal chair. This was later endowed as the ARC Chair of Rheumatology at The London Hospital Medical College (University of London). When Will Tegner retired in 1968, Colin Barnes joined Michael Mason and Harry Currey on the consultant staff of the department.

He developed rheumatology at Notley Hospital, which was then still largely a TB hospital with a large orthopaedic unit, attending for monthly combined clinical sessions with orthopaedic colleagues from both Chelmsford and Colchester. This continued until he handed over that clinic to Colin Barnes in 1969 by which time the largely physical medicine departments in Colchester and Chelmsford were developing into departments of rheumatology.

Harry Currey, Michael Freeman (experimental orthopaedics) and Barrie Vemon-Roberts (osteoarticular pathology) joined forces to form the Bone and Joint Research Unit (BJRU), initially working from their separate and cramped accommodation. Michael Mason's influence in this development was both evident and essential leading to the construction of the ARC Building at The London to house the BJRU, which was formally opened by HRH the Duchess of Kent, Patron of the Arthritis and Rheumatism Council (now the Arthritis Research Campaign) in early 1977. It was fitting that the seminar room in the ARC Building was named ‘The Michael Mason Room’ in his lifetime.

Michael Mason's appointment with the NHS was always less than maximum part-time, and he developed a successful private practice—successful only because he offered such an expert, thorough and individual service to his patients. He was in constant demand being asked to fit in extra patients to his already full consulting sessions, to see colleagues' patients in many hospitals as well as doing daily ward rounds of his own in-patients. Nevertheless he never failed to discharge his sessions in the NHS and, as one might expect, usually was late for appointments outside the hospital having overrun his sessions there.

Despite his incredibly busy clinical, teaching and research load Michael Mason was a leader in the broader field of rheumatology. In 1955 he was invited by his former chief, Dr W. S. Copeman to become the Honorary Medical Secretary of the Arthritis and Rheumatism Council. He was appointed Chairman of the Executive Committee of the ARC following Dr Copeman's death in 1971 and held that position until his own death in 1977. Under his leadership the ARC continued to grow, income passed the £1 m mark for the first time in (about) 1974, four rather than one Hon. Medical Secretaries were needed, and research funding expanded enormously. He was also President of the British Association of Physical Medicine and Rheumatology (later the British Association of Rheumatology and Rehabilitation) (1968–71), of the Heberden Society (1974), being the first to hold both these Presidencies, and of the British League Against Rheumatism (1973–77). He played his full part in committee work at The London and on the North-west Thames Regional Advisory Committee on Rheumatology. He was visiting Professor to the University of Sydney in 1967. He was the author of many papers, chapters in books and, with Harry Currey, was co-author of ‘An Introduction to Clinical Rheumatology’ [5], a textbook for students and junior doctors which first appeared in 1967 and went through three editions before his death and a fourth in 1986. He travelled widely to rheumatology conferences and had a wide circle of friends at home and abroad.

He was a devoted family man, a keen sailor and an expert skier. He disciplined himself to leave London on Friday evenings, whenever possible, for his home in Frinton and would spend weekends (weather permitting) and holidays sailing his beloved Gosforth Maid, a 33-foot yacht. He would then return to London late on a Sunday or early Monday for another strenuous week's work. He was supported greatly in this hectic programme by his wife Heather who always seemed to have a meal ready, often for many visitors, a suitcase packed or the car at the door when necessary.

Michael had his first coronary thrombosis in 1969 but, after an appropriate period off work, returned with instructions to reduce his work load. This he did by giving up sessions at Notley and The Royal Masonic Hospitals and by strictly reducing evening and weekend commitments. However, gradually he seemed to be as busy as ever. He died from a further myocardial infarction in the early hours of the morning of Thursday 30th June 1977 while attending the International Congress of Rheumatology in San Francisco, a few hours before he was due to attend, and contribute to, a session on Behçet's Syndrome. He had already submitted his resignation to The London Hospital as he had planned to retire on his 60th birthday on 27th September 1977 and his advice had been sought about the structure of the post to be advertised for his successor. His funeral was on 7th July 1977 in Walton-on-the-Naze in a church packed with friends and colleagues followed by a reception arranged by his family, appropriately, in the Yacht Club. A memorial service was held in the church of St Clement Danes, Strand, London, the RAF church, on Friday 16th September 1977 attended by a vast number of family, friends, colleagues and patients. He was survived by his wife Heather, who sadly died three years later, and by their son and daughter.

It can be said that Michael Mason was a pioneer and leader in British rheumatology, a man of great vision, a superb clinician and friend to his patients, who led life to the full and who sadly died before he could enjoy his planned retirement.

References

  1. Tegner W, Mason M, Barnes CG. The London Hospital Department of Physical Medicine and Rheumatology. Ann Phys Med 1968;10:218–22.
  2. Mason RM. Ann Rheum Dis 1954;13:120.[ISI][Medline]
  3. Mason RM, Currey HLF, Barnes CG et al. Azathioprine in rheumatoid arthritis. Br Med J 1968;1:420.
  4. Mason RM, Barnes CG. Behçet's syndrome with arthritis. Ann Rheum Dis 1969;28:95–103.[ISI][Medline]
  5. Mason RM, Currey (eds). An introduction to clinical rheumatology. London: Pitman Medical, 1970. Obituary Br Med J 1977; ii: 198. Rheumatol Rehab 1977;16:199–200. Ann Rheum Dis 1977;36:484–5.[Medline]




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