Hewan Dewar MD, FRCP
(1913 – 5 November 2012)
Former Consultant Physician Royal Victoria Infirmary, Newcastle upon Tyne.
Few of my undergraduate teachers made as much impression as Hewan Dewar during my clinical training in Newcastle. Stories about him abounded, but the one I experienced was a corker:
Dewar: “What did you hear when you listened to the heart, Jones?” (During a teaching session in the valve clinic).
Smith: “Er, aortic incompetence, Dr Dewar?”
Dewar: (peering over his half moon glasses, with a twinkle in his eyes) “there may be some incompetence here Jones, but it’s not aortic!”
But of course this is only a tiny component of his contribution to cardiology in Newcastle and the wider cardiology world. There is much fascinating detail of Dewar’s professional life in the BMJ editorial on the web: (http://www.bmj.com/content/346/bmj.f266) and in his lovely little book: “The Story of Cardiology in Newcastle” which he had published at his own expense in 1998.
Dewar was educated in Edinburgh, having been born and brought up in Stanley, Co Durham. He attended medical school in Newcastle, at that time known as Armstrong College. Dewar refers to acrimonious relationships between the college in Newcastle and the University in Durham, and this contributed to the re-naming of the university component in Newcastle as King’s College.
He graduated in 1935, and received his degree at a ceremony in Durham. His class of 54 contained six women, a far cry from today’s proportions! His early posts were at the RVI in Newcastle and at the Postgraduate Medical School in London. Then, after enlisting in the reserves, he was called up and was sent to Palestine as a physician. After demobilisation he was appointed at the RVI as a registrar, becoming consultant in 1947. He continued to work at the RVI as the only cardiologist until his retirement in 1978. Of course as cardiologist at that time his role also included the general medical reception, and he had a reputation as having considerable skill in that role as well.
He introduced many academic and clinical advances at the RVI, so it is a shame that there were two miles between him and the Regional Cardiac Centre set up at the General Hospital. He did attend joint meetings and published with the staff there, but it is clear that, as he mentions (in “The Story of Cardiology in Newcastle”), even in the 70’s, the difficulty of parking contributed to the two units remaining rather separate.
His clinical advances included, with the help of Dr Peter Hacking, the establishment of cardiac catheterisation at the RVI. I can clearly remember standing as a student in a dark room while Dewar and Hacking performed a coronary angiogram. We thought it all very technical at the time, and wondered about its relevance! He also set up the Coronary Care Unit at the RVI in 1968. I have heard a story that there were occasions on which he slept in the hospital soon after the unit was set up. The story went that he was “wandering” round the ward in his dressing gown and was shooed “back to his bed” by a kindly young student nurse who failed to recognise the great man. I am afraid I cannot attest to the veracity of the story, but imagining the scene may amuse those who knew him. A more dramatic innovation perhaps was the Coronary Ambulance, driven initially by junior doctors, to provide care and in particular, defibrillation, at the homes of victims of myocardial infarction. This task was taken over by ambulance drivers six months later, and the service continued until Dewar’s retirement. Unfortunately, he was unsuccessful in attempting to establish training for ambulance personnel as paramedics, yet another far-sighted idea which has come to fruition in his lifetime.
His academic work was almost single handed yet he made a mark in areas which we now take for granted. For example, he organised a controlled clinical trial of Clofibrate, a forerunner of the statins. But it was his investigations into the role of fibrinolysis, particularly in acute myocardial infarction, that are most notable. He undertook a study of the effects of intracoronary fibrinolysis in acute infarction treating eight patients in the mid 1970s, to demonstrate that thrombus could be lysed in this situation. It is important to recall that there was even at that stage some controversy as to the critical role of intracoronary thrombosis in the pathogenesis of myocardial infarction. This report unfortunately received little attention, and indeed considerable criticism at a meeting of the British Cardiac Society at which it was presented, I understand. Dewar retired soon after this, and his co-worker (aka senior registrar), Dr Roger Smith, was appointed to his consultancy in North Tees, and the work ended. However Dewar continued research activity after retirement, publishing in collaboration with the Department of Pathology at the RVI.
During retirement he was very active in Northern Ash, putting a considerable amount of effort into publicising the harmful effects of smoking, eventually realising that legislation was what was needed.
He also continued to attend the Association of North of England Physicians meetings, attending every one until his 92nd birthday. After setting up the organisation (then the Association of Physicians of Region No.1) he was always a strong supporter, being honorary secretary for 27 years and president for nine. Indeed my last memory of Dr Dewar is a typically insightful question asked at an Association of Physicians meeting in what must have been his late eighties.
Dr Dewar died peacefully at home on 5th November 2012, at the age of 99 years, survived by his wife, Margaret, his son, John, a recently retired oncologist, and his daughter, Caroline, and several grandchildren and great grandchildren.
A Service of Thanksgiving was held at St. Oswin’s Church, Wylam on Tuesday 13th November.
Obituary by Dr Phil Adams