OBITUARY: Professor Charles Fletcher

The son of Sir Walter Morley Fletcher, the first Secretary of the Medical Research Council; educated at Eton and Trinity College, Cambridge; an oar in the victorious Cambridge boat of 1933: with his background, Charles Fletcher could have been assumed to be a pillar of the establishment. Far from it - Fletcher was a radical free-thinker, who made major contributions to the medicine of his day. He will be remembered particularly for his pioneering of medicine on television, his work on the dust diseases of coalminers, his campaigning on the hazards of cigar- ette smoking and for emphasising the importance of communication in medicine.

He was born in 1911. After Eton and Cambridge, he studied Medicine at St Bartholomew's Hospital, graduating in 1937. He later worked with Professor Leslie Witts at the Radcliffe Infirmary in Oxford, where in 1941 he was the first doctor to inject penicillin, newly prepared by Howard Florey and Ernst Chain, for the treatment of infection in a human subject. It was then that he diagnosed his own diabetes, necessitating lifelong injections of insulin, an affliction bravely borne for more than 50 years. There were moments when hypoglycaemia disturbed his spirits, as when he told his wife that the end of the world was at hand. Her response was to ask him to take a lump of sugar before that happened.

When the Medical Research Council sought a clinical scientist to head their newly established Pneumoconiosis Research Unit in Cardiff, Sir Edward Mellanby, successor to Fletcher's father, had no hesitation in selecting Charles Fletcher. It was an inspired choice. Fletcher was able to establish the closest relationship with the trade unions and the community of miners in South Wales. He also proved to be a remarkable talent scout, recruiting such individuals as the epidemiologist Archie Cochrane to his unit.

In 1952, Sir John McMichael invited Charles Fletcher to join his Department of Medicine at the Postgraduate Medical School at Hammersmith Hospital. It was not an entirely happy move. Fletcher's interest in epidemiology, the study of disease in the community rather than in single subjects in a hospital environment, was not given the support that he deserved. Nevertheless he was able to show conclusively that patients with chronic bronchitis would do better if they stopped smoking than if they were treated with expensive antibiotics.

It was at this time that he took a role in the anti-smoking campaign. Sir Richard Doll and Sir Austin Bradford Hill had shown that the modern epidemic of lung cancer was associated with cigarette smoking, but it was Fletcher, with the support of Sir George Godber at the Department of Health, who persuaded the Royal College of Physicians to produce their epoch-making report in 1962 on the hazards of smoking. Fletcher himself was effectively the author of that report.

Tall and distinguished in appearance, and with thespian qualities, Charles Fletcher was perhaps a natural choice for television. It was he who, from 1958, collaborated with Richard Dimbleby in the production of the first major television series that dealt with medicine, Your Life in Their Hands. He was attacked by his professional colleagues for seeking personal publicity, something he would never have done, and his desire to see medicine not as a secret garden but as a subject for general debate has in time been fully vindicated.

Fletcher retired in 1975, but continued his campaigning. He gave an inspiring Rock- Carling lecture on the importance of communication in medicine, emphasising how doctors should explain to their patients what they were up to. He enjoyed his home in the Isle of Wight, where he was to suffer the first of the final cerebral episodes that were to end his life. He is survived by his wife Louisa, daughter of the first Baron Mottistone, and by his three children, one of whom, Susanna, is the wife of the Attorney-General, Sir Nicholas Lyell.

Christopher Booth

Charles Montague Fletcher, physician: born 5 June 1911; Director, MRC Pneumoconiosis Research Unit 1945-52; CBE 1952; Physician to Hammersmith Hospital 1952-76; Reader, London University at Royal Postgraduate Medical School 1952-73, Professor of Clinical Epidemiology 1973-76 (Emeritus); Secretary, MRC Committee on Bronchitis Research 1954-76; Secretary, Committee on Smoking and Health 1961-71; Chairman, Ash 1971-78, president 1979-95; married 1941 Louisa Seely (one son, two daughters); died 15 December 1995.