Norman Barrett

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Norman Rupert Barrett (1903–1979) was an Australian-born British thoracic surgeon who is primarily remembered for describing Barrett’s oesophagus.

Early life[edit]

Norman Barrett was born on 16 May 1903 in Adelaide, South Australia, to Alfred and Catherine Barrett. His great uncle, James Barrett, was a doctor, and four of James's children became doctors. One of these children, Norman's uncle Sir James Barrett, was a founder of the Royal Australasian College of Surgeons and a Chancellor of Melbourne University. He moved to England at the age of 10, and was educated at Eton College and Trinity College, Cambridge. He was given his lifelong nickname, Pasty, while at Eton.[1]

Career[edit]

He trained at St. Thomas’ Hospital, and graduated in 1928. He continued as resident assistant surgeon at St. Thomas’ Hospital, and was elected as Fellow of the Royal College of Surgeons in 1930. He was awarded the postgraduate degree M Chir in 1931. In 1935, he became a Consultant Surgeon at St. Thomas’, where he remained for the rest of his career.

He travelled to the United States on a Rockefeller Travelling Fellowship from 1935 to 1936, working at the Mayo Clinic, and visiting Boston, St. Louis and Michigan. It was during this time that he decided to focus on thoracic surgery, rather than gastrointestinal surgery as he had initially intended.

In 1946, he wrote a paper for the first issue of Thorax on spontaneous rupture of the oesophagus (Boerhaave syndrome), in which he commented that "in the byways of surgery there can be few conditions more dramatic in their presentation and more terrible in their symptoms than spontaneous perforation of the oesophagus. No case has yet been treated successfully, and diagnosis has only been achieved in a very few before death".[2] A year later, on 7 March 1947, he performed the first successful repair of a ruptured oesophagus.[3]

In 1950, he published a paper in which he described the oesophagus as "that part of the foregut, distal to the cricopharyngeal sphincter, which is lined by squamous epithelium".[4] In this paper, Barrett suggested that the finding of an oesophagus lined with columnar epithelium (rather than the usual squamous epithelium) was due to the presence of a congenitally shortened oesophagus leading to a tubular portion of stomach being trapped in the chest. In this article Barrett also introduced the term reflux oesophagitis, and described the development of benign oesophageal strictures in patients with this condition.

Allison and Johnstone argued that this columnar epithelium–lined structure was oesophagus and not stomach, and suggested that ulcers in this structure be called "Barrett's ulcers".[5] Seven years after his initial article Barrett accepted this view, suggesting that it be called the "lower oesophagus lined by columnar epithelium".[6] The columnar epithelium surrounding the chronic Barrett's ulcers has subsequently become known as Barrett's oesophagus.[7]

In addition to his work on oesophageal disease, Barrett also worked with Leonard Dudgeon, Professor of Pathology at the University of London, on the cytology of sputum in the diagnosis of pulmonary malignancy.[8] He is also noted for his treatment of hydatid cysts.[9]

Barrett was a lecturer in surgery for the University of London (1935–1970), Surgeon to King Edward VII Sanatorium in Midhurst, Sussex (1938–1970), and Consulting Thoracic Surgeon to both the Royal Navy and the Ministry of Social Security (1944–1970).[10] He edited Thorax, the journal of thoracic surgery, from its inception in 1946 until 1971.

Personal life[edit]

Norman Barrett married Annabel Elizabeth "Betty" Warington Smyth on 21 April 1931. She was the sister of a school friend, and they had met six years previously. Betty had studied English and Art, and later became a novelist. They had two children, Julia and Althea. After Norman had been appointed a Consultant at St. Thomas’ Hospital, the Barrett family lived at 2 Dorset Street, Marylebone, London for about 20 years. In 1954 they moved to Richmond Green.

Outside his medical interests, he was also interested in the history of medicine, drawing and painting, and was a keen sailor.

He was awarded the CBE in 1969, and retired in 1970. He died in London on 8 January 1979.

References[edit]

  1. ^ Lord, RV.; Barrett, N. (Mar 1999). "Norman Barrett, doyen of esophageal surgery.". Ann Surg 229 (3): 428–39. doi:10.1097/00000658-199903000-00018. PMC 1191710. PMID 10077057. 
  2. ^ Barrett NR. Spontaneous perforation of the oesophagus. Review of the literature and report of three new cases Thorax 1946.1:103-6
  3. ^ Barrett NR. Report of a case of spontaneous perforation of the oesophagus successfully treated by operation. Br J Surg 1947,35:218
  4. ^ BARRETT NR (October 1950). "Chronic peptic ulcer of the oesophagus and 'oesophagitis'". Br J Surg 38 (150): 175–82. doi:10.1002/bjs.18003815005. PMID 14791960. 
  5. ^ ALLISON PR, JOHNSTONE AS (June 1953). "The oesophagus lined with gastric mucous membrane". Thorax 8 (2): 87–101. doi:10.1136/thx.8.2.87. PMC 1019247. PMID 13077502. Retrieved 2009-01-24. 
  6. ^ BARRETT NR (June 1957). "The lower esophagus lined by columnar epithelium". Surgery 41 (6): 881–94. PMID 13442856. 
  7. ^ Spechler SJ, Goyal RK (February 1996). "The columnar-lined esophagus, intestinal metaplasia, and Norman Barrett". Gastroenterology 110 (2): 614–21. doi:10.1053/gast.1996.v110.agast960614. PMID 8566611. 
  8. ^ Barrett NR. Examination of sputum for malignant cells and particles of malignant growth. J Thorac Surg, 1938;8:169-83
  9. ^ Barrett NR. The treatment of pulmonary hydatid disease. Thorax 1947;2:21-57
  10. ^ AIM25 archive of Norman Barrett