Neurosurgeon; Born March 1, 1926; Died January 26, 2008.
Bryan Jennett, who has died aged 81, was professor of neurosurgery at Glasgow University from 1968 to 1991 and the leading academic neurosurgeon of his era. Like giants such as Lister and Macewan, professors of surgery at the university a century earlier, he changed the face of his field, and left an even wider legacy.
Jennett was born in Twickenham to Scottish and Irish parents. After a time on the family farm in Lanarkshire during the war, agricultural college beckoned, but he finally decided to study medicine.
His intellectual calibre and leadership qualities first showed at Liverpool Medical School, where met his wife, Sheila. In 1949 he finished top of his class and was president of the local medical students' society and the British Medical Students' Association. Lectures on neurology from Lord Cohen and experience with Sir Hugh Cairns in Oxford developed his interest in neurosurgery.
His desire for a career that would combine clinical and laboratory research found expression with his appointment as consultant in Glasgow in 1963. Encouraged by Sir Charles Illingworth and supported by other colleagues, he developed a thriving research programme and was appointed professor of neurosurgery in 1968.
His brilliant, logical and inquiring mind led him to question all that he did and to seek rational, definitive answers to the many problems faced by neurosurgeons. The Glasgow unit became a magnet for trainees and researchers from all over the world. (At one time, seven out of 10 professors in neurosurgery in the UK were Glasgow trained.) Jennett inspired young surgeons, fostered their ideas and supported them enthusiastically and generously throughout their careers. He was at his finest correcting drafts of papers, unable to resist making improvements to the point of almost completely rewriting them. He had a talent for forging collaborations that stimulated scientists in other disciplines to bring their talents to bear on his major interests: head injury and the mechanisms of acute brain damage, hitherto of little interest to doctors. Pioneering work followed, applying laboratory science to clinical practice. The experimental and clinical studies of a cerebral circulation group, co-directed with Murray Harper, advanced understanding of disorders of cerebral blood flow and intracranial pressure and led to new standards in neuro-anaesthesia and the care of patients with head injuries.
Long-standing uncertainties in establishing a prognosis for such injuries represented a significant challenge, which was gradually unravelled through a description of the Persistent Vegetative State (1972), with a leading American neurologist, Dr Fred Plum; the Glasgow Coma Scale (1974), with Graham Teasdale (who succeeded him as professor) and the Glasgow Outcome Scale (1975), with Michael Bond, later professor of psychological medicine in Glasgow. Two of these papers were selected as the most significant published by the Lancet in that year.
International collaborative studies of prognosis and treatment followed, unique in their statistical rigour, scale and continuity. Close collaboration with the department of neuropathology, led by Professors Adams and Graham, highlighted avoidable causes of brain damage and in turn helped to develop guidelines for organised clinical management that significantly reduced mortality and disability. The output of the "Glasgow School" revolutionised the management of head injured patients worldwide.
Another crucial contribution was in establishing the criteria for "brain death"; an outstanding piece of clinical work and an important piece of philosophy. When the inevitable opposition arose Jennett remained resolute. His understanding of the mechanisms of brain damage, his ability rapidly to accumulate and analyse clinical data and to communicate his findings and convictions with telling clarity, were crucial in restoring professional and public confidence. Without his courageous, committed and at times uncompromising stance, transplantation programmes could have been set back for years.
While dean of medicine in Glasgow from 1981 to 1986, the breadth of his intellect and instinct for diligent, rational analysis became increasingly applied to issues across medicine and its interface with society. Thinking ahead of his time, he addressed the appropriate use of high-cost technology, organising with Barbara Stocking of the King's Fund a series of consensus conferences, and became president of the International Society for Technology Assessment.
Jennett's gifts as a communicator made him much in demand as a speaker. His written outputs included Introduction to Neurosurgery which ran to five editions between 1964 and 1995. He retained an active interest after he retired. A monograph titled The Vegetative State, Medical Facts, Ethical and Legal Dilemmas, brought together his broad views on this contentious topic and a final brief publication The Early Diagnosis of Spinal Tumours: A Personal Story Spanning 50 Years, appeared in the Journal of Neurosurgery one month before his death.
Outside medicine, he and Sheila, a professor of physiology, were keen cruising sailors on the west coast of Scotland. Jennett was a founder member and later commodore of the medical Serpent Yacht Club. From the 1960s the family had a second house in Lochgoilhead, from which sprung memorable sailing adventures. Two sons completed transatlantic crossings and a third is a qualified yachtmaster. Although notably tone deaf himself, Jennett was a great sponsor of musical activities within the family and his daughter became a professional cellist.
He was made a Commander of the British Empire in 1991 and received an Honorary DSc from St Andrews University in 1993. He leaves his wife Sheila, three sons, a daughter, seven grandchildren and one great grandchild.
- By Sir Graham Teasdale and Sam Galbraith
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