President of the Nottingham Medico-Chirurgical Society

1989 - 1990

Tony Mitchell was a Lancashire man and it is not surprising that he became a medical student at Manchester. There is progress his progress was no less than triumphant. Effortlessly he won every prize open to him and topped the examination lists time after time. It was in Manchester as a student that he consolidated his natural gifts of clear thinking, plain speaking and cool clear logic. Theses were to serve him well in the years to come.

After qualification he became resident house physician to Robert Platt where he learned that talking to patients was more important than talking about them, that he needed to be involved yet emotionally detached, and that at all times he was required to be in command of his professional skills. He established for himself some basic ground rules: offer facts first and opinions later, challenge established ideals, and ignore cant and rhetoric.

After a spell of national Service in the Royal Army Medical Corps Tony Mitchell was appointed Registrar to Sir George Pickering, Regius Professor of Medicine at Oxford. He had in fact be appointed to a registrarship at the Hammersmith Hospital, London the day before his Oxford interview but he kept the Postgraduate Medical School waiting until he obtained the post he really wanted. This showed, as a young man, his cheerful antipathy to authority and to the establishment which he kept for the rest of his life. At Oxford he developed his personal philosophy of academic medicine from which he never deviated and which sometimes led him into conflicts with other academics whose feet were not so well grounded with the mud of the real world. But he was a true academic in the sense that he asked questions and required answers based on facts rather than opinions and Oxford convinced him of the intrinsic role of the academic physician. He was to apply these academic standards to clinical medicine when he moved to Nottingham.

His basic laboratory research contributions on thrombosis and platelets were made at those eleven years at Oxford. His chiefs were Professor Gwyn Mcfarlane and Sir George Pickering though it was Pickering who was really his mentor. Michael Oliver, a colleague at the time, recalls that Pickering instructed Tony to team up with Colin Schwarts, a young Australian pathologist, who at the time was working with Robb Smith. Armed with a bacon slicer, countless hearts and post-mortem angiograms they became a series of innovative studies on the role of thombosis in the genesis of myocardial infarction (heart attack). This work gained Tony a D.Phil and was summarised in his book ‘Arterial Disease’ which he wrote in collaboration with Schwarts.

The turning point in Tony’s career came in 1968. In July 1964 Mr. Anthony Barber, who was then Minister of Health, had announced that the new medical school that had been promised to the country was to be established in Nottingham. Many wondered why Nottingham had been chosen as the site of the new medical school, the first in the UK since the Welsh National School of Medicine was created in 1938. There were two reasons – one good and one bad. The good reason was that Nottingham had already the site of a thriving University with facilities as old as theology and as new as social sciences. The bad reason, necessitating the creation of a new medical school in the East Midlands, was for many years this part of the UK had been a medically deprived region; it was short of hospitals, short of doctors and short of money.

By a happy chance Sir George Pickering, a reforming medical educationalist, was selected to chair the Medical School Advisory Committee which published its report in l965 recommending a Teaching Hospital and Medical School   complex adjacent to the University campus. It came as no surprise that Tony Mitchell was appointed to the Foundation Chair of Medicine.

At this time when the motorway had scarcely reached Nottingham, the new Medical School was housed in dreary, flat buildings on the University site, affectionately known as the cowsheds (later gentrified to Cherry Tree Buildings).  The two old, but much respected Victorian hospitals in the city were renovated and expanded to cope with the influx of new medical students and work was started on what was to be the Queen’s Medical Centre. At this time Tony was joined by Michael Langman as Senior Lecturer, who was later to become Professor of Therapeutics in Nottingham and Professor of Medicine in Birmingham. In the ensuing years Tony Mitchell never missed an opportunity of making something from almost nothing. He channelled his abundant vigour into administration, research, teaching and patient care to convert the deprived Nottingham hospitals into centres of excellence. Provided there was space in his diary he never turned down a request for help; determined and careful planning were of were of critical importance. With John Hampton, Later Professor of Cardiology, Stan Heptenstall, Keith Morris and Bob Wilcox he welded together a formidable team which showed the world how to conduct trials of therapy in cardiovascular disease. With the opening of the Queen’s Medical Centre in the yearly 1970’s activities prospered and the flow of publications to prestigious journals was but a trivial marker of the calibre of his teams work. Though he was much in demand as a speaker – and indeed if Oscars were given for lectures he would have won many – he was never away long from his department.

When Tony arrived in Nottingham as Professor of Medicine he also came as a much needed additional consultant physician at both the Nottingham City and the General Hospitals, where not only facilities but staff were at dangerously low levels. Perhaps not surprisingly many local people expected the new professor to take over the care of those patients with rare and exotic diseases which had been perplexing his local consultants for years. Characteristically Tony had different ideas! He chose to look after patient with common but neglected diseases. His particular contribution was the care of patients who had had a stroke and he encouraged and supervised the development of the Nottingham Stroke Unit. He had the happy knack of being able to talk to patients in their own language and wasn’t afraid to call a spade a spade or whatever he wanted to call it! His own notes, written in that neat hand, rarely corrected, were for the benefit of others only. He never needed to refer to them again. His prodigious memory allowed him to remember every detail years later.

On the wards he was never internationally famous professor trailing a retinue of assistants and visitors. His were working rounds where he new every patient, every nurse and very ward assistant. For one so tough and incisive in the committee room or lecture hall he could talk with gentleness and humility to those frightened little old ladies who were his patients.

Tony held strong views about many topics in contemporary life. For him private practice had no place in the NHS and his own special patients were largely ordinary folk with ordinary diseases; though it must be said that he collected more than a few bizarre problems! He couldn’t stand the do-gooder health educationalists, a breed he regarded with particular distrust and suspicion. He abhorred clap-trap and pomposity and could indulge in a remarkably effective character assassination when he really put his mind to it.

As is often the case with busy people, this talented man had a full and productive life away from his professional work. He was blessed with a happy marriage to Muriel, whom he met at school, and whose quiet support brought stability and continuity into his eventful life. His interests were numerous and to call all of them he brought great enthusiasm, energy, efficiency, common sense and a rich store of knowledge generated by his splendid memory. He was into boats from his early days, out with the trawlers in Morecambe Bay. In later years he confessed surprisingly, of his own nervousness at high seas. When he became land-locked in Nottingham he took to the canals, those rivers which run uphill, which never failed to fascinate him. Whilst in Oxford he took to gliding and at coffee times there were tails of downdrift, cumulus clouds and wind gradients. But perhaps his greatest love was music and it was in Nottingham that he achieved one of his major ambitions – to join an orchestra! There he discovered that his own medical students played better than he did, but of course he was able to compensate by providing erudite and witty programme notes.

He took much pride in his adopted city and within a year or so of arrival he knew more of the geography and history of Nottingham than many of those born and bred there. He accepted the Vice-Chairmanship of the Nottingham Civic Society with some reluctance, preferring to be a rank and file member, happily trudging through the backstreets, captivating his companions with snippets and titbits from the past. In the year of his retirement, to the great delight of his colleagues, he honoured the Nottingham Medico-Chirurgical Society by becoming its president.

Sadly he died, suddenly and unexpectedly, in 1991, having enjoyed no more than a few months of pleasurable retirement. His bust, sculpted by a colleague, Kelvin Thomas, FRCS, which stands in the entrance hall of the Nottingham Medical School, bears this inscription:-

Professor J R A Mitchell, BSc, MD (Manchester), MA,

DPhil (Oxford), FRCP

Foundation Professor of Medicine, 1968-90

Si monumentum requiris, circumspice

If you seek his monument look around you

SURGEONS Nottinghams Eminent Surgeons and Physicians