Obituary: Dr Ian James

MUSIC AND medicine often go together - Borodin is just one of a number of distinguished doctor-composers while many doctors are involved in amateur music-making - and in the case of Ian James it was a particularly fruitful and happy combination.

It led to his founding in 1989 of the British Association of Performing Arts Medicine. This is now a flourishing concern backed by the Musicians' Union, the Musicians Benevolent Fund and Equity and has helped thousands of musicians. It provides a telephone help-line, it runs special clinics, one of which James ran at the Royal Free with involvement of doctors, therapists, psychologists and specialist instrumentalists who advise on technique - all of whom give their services free. The trust has trained 35 GPs in music medicine who are attached to all the major orchestras and opera companies in Great Britain.

James was fortunate in a happy childhood. His father - who taught Dylan Thomas English - was the legendary headmaster of Gowerton Grammar School, and so inspired him with a love of music that he gained a place as a viola player in the National Youth Orchestra of Wales. Medicine however won him over and he qualified from University College Medical School in London at the age of 23. In due course he joined Professor Ivor Mills's research department at Cambridge. Here his PhD thesis on the control of blood flow to the brain gained him international recognition.

At the age of 31 he was appointed Consultant in Clinical Pharmacology and Therapeutics at the Royal Free Hospital and subsequently became Reader. He made a study of the drug treatment of hypertension, depression and ME. His understanding of this tragic illness and his holistic management transformed many lives, as witnessed by the deluge of letters to his widow.

His interest in drugs stood him in good stead when he suffered severe nerves during an orchestral rehearsal. Each member of the viola section was asked to play a particular passage solo. James's bow tremor significantly affected his performance and he resolved to experiment with Beta Blockers to stop the tremor.

The successful use of this drug led to a study with a number of colleagues on the effect of Beta Blockers on the nervousness and level of performance in 24 string players at the Wigmore Hall. The drug had a significant effect on bow tremor, intonation and anxiety.

However James realised that drugs were not and should not be the only answer to performance anxiety. The causes needed to be sought in the background of the player, their lifestyle and their approach to their art. He showed convincingly that orchestral musicians in Britain suffer an inordinate amount of stress. He used to say repeatedly in public that they worked three times as hard as their continental colleagues for half the money.

Last year a highly successful international conference in music medicine was held in York under the aegis of the International Federation of Musicians inspired and largely organised by Ian James. He also took on for many years the chairmanship of the International Society for Prevention of Stress in Performance created by the enthusiasm of Professor Carola Grindea.

His obsession with Mozart led him to research the archives in Salzburg to discover the cause of his hero's death. His view, published in 1991 during the 200th anniversary of Mozart's death, led to a controversial and lively public debate but James remained convinced that his doctors had unwittingly poisoned Mozart with the mercury used for his chronic illness. Latterly he championed the cause of the viola d'amore - the loveliest of instruments, he said - and was deeply involved in the society in order to promote the instrument.

A dynamic bustling man of short stature but great presence, Ian James exuded optimism, excitement for life and fascination with people. His temper could be short on occasions but after the storm the sun came out with renewed radiance. He was an electrifying public speaker, laying out the basis of his convictions with authority and careful reasoning and then, suddenly, catching the audience's breath in a crescendo of passionate advocacy, he caught everybody up into his hwyl.

It seems incredible that one man achieved so much in such a short time. He married the concert violinist Jane Faulkner in 1987; it gave him great pleasure to live closely with a professional musician and there is no doubt that she inspired him in his continuing work in music.

Kit Wynn Parry

Ian Meurig James, medical practitioner and viola player: born 15 February 1937; married 1968 Margery Lovatt (two daughters; marriage dissolved 1986), 1987 Jane Faulkner (one son, one daughter); died London 19 August 1998.