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Anthony Hopkins* was to have edited this supplement. Its title “Neurology and Public Health”, drawn from the subject of the meeting held at the College of Physicians, is characteristic of the man and points to his burning interest in how medical practice can best meet the needs of patients. Everything he did and everything he said, as at the lecture he was giving at the College when he suddenly developed his fatal illness, was aimed at ensuring that the system in which we operate can be made to provide the highest quality care.
The following is an extract of a personal view of Anthony which I expressed at an evening of celebration of his life which was held at the Royal College of Physicians in May 1997.
Loose thinking, illogicality, pomposity, superficiality, and laziness were all characteristics which Anthony abhorred in others and, of which, he himself had not a trace. And this, of course, is one of the reasons why he inspired such great affection in so many people around the College, while making others feel a little uneasy at the possibility of being found out.
Anthony was appointed as Director of the Research Unit in 1988 so that when I arrived in 1992 he was well established and running an enormously successful organisation that he had very rapidly developed. It did cross my mind to wonder how this chap who seemed to float along so effortlessly could be producing the 100 plus articles, the 30 or more sets of guidelines to good practice, the 20 odd books and still be able to seem so laid back? He must be paddling pretty vigorously beneath the surface of the water; and, indeed, he was.
That, of course, was but one of the many paradoxes which made up the complex man. If you were to ask different people around the College what Anthony meant to them, you were liable to get a wide range of answers and that was, at least, partly because he had what seemed to be a number of incompatible characteristics.
For example, on the one hand, he seemed almost shy and diffident, but on the other, he was fearless and outspoken. I remember him slipping in, almost unnoticed, to meetings of College Officers or to Council and sitting quietly there while all around him were sounding off at great length, and everyone else nodding agreement. And suddenly, Anthony would come in with a contrary view which made everyone; me included; stop and stare, and he would go on to explain his view with that clear logic of his which was so difficult to refute. And, of course, he was able to defend his opinion against the majority with complete confidence in himself and his view.
And that brings me to the next paradox because he was not only clear, logical, and analytical in his thoughts, his lectures, and his writing, he was also a lateral thinker. I am not sure whether it is paradoxical to be able to be direct and to the point, and also to be able to think sideways, but he could and did do that.
And then he seemed, on the one hand, to be part of the establishment; after all, he was an Officer of the Royal College of Physicians; but many saw him as an antiestablishment figure and, I believe, he thought of himself in that way. He was, indeed, somewhat uncomfortable for the establishment and I suppose that is because one of the characteristics of establishments is their unwillingness to change and Anthony was a changer, which gave him his rather maverick edge.
He was ahead of his time in many things and an obvious example was this novel idea that he had that we should ask the patients themselves what they thought about their illnesses and their treatments. He had already published widely in the field of how you might measure the quality of care, the quality of life, and the quality of outcomes of care, at a time when all about him were busy measuring the quantity of care.
Of course, it was this direct involvement of patients with, for example, the various patient associations, and the public which earned him considerable respect and admiration, and it was his accessibility to patients which endeared him to so many.
He was way ahead of his time, too, in promoting the idea that we, in the medical profession, should check how well, or otherwise, we were doing for patients through medical audit. He was, again, more recently, ahead of some, at least, in pointing out so clearly where audit was going wrong in practice.
Despite his penetrating intellect and sharp critical faculties which so often discomforted those whose thought processes were rather loose, he was an extremely popular figure and his views were eagerly sought. He was able to seek out a wide range of collaborators for his research programmes up and down the country, and the fact that he was able to raise vast amounts of research grant income to support all of this activity, relied heavily on his high intellect and ability, combined with great personal charm and persuasiveness. And, of course, the fact that people around him simply enjoyed working with him.
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