Richard Asher

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Richard Asher
Richard Asher for Wikipedia.jpg
Born Richard Alan John Asher
(1912-04-03)3 April 1912
Brighton, Sussex [1]
Died 25 April 1969(1969-04-25) (aged 57)
Marylebone, London [2]
Cause of death
Suicide[3]
Occupation Physician
Spouse(s) Margaret Augusta Eliot
Children Peter Asher
Jane Asher
Clare Asher
Parents Felix and Louise Asher née Stern

Richard Alan John Asher, FRCP (3 April 1912, Brighton – 25 April 1969, Marylebone) was an eminent British endocrinologist and haematologist.[3] As the senior physician responsible for the mental observation ward at the Central Middlesex Hospital[4] he described and named Munchausen syndrome in a 1951 article in The Lancet.[5]

Personal life[edit]

Richard Asher was born to the Reverend Felix Asher and his wife Louise (née Stern). He married Margaret Augusta Eliot at St Pancras' Church, London on 27 July 1943,[6] whereupon his father-in-law gave him a complete set of the Oxford English Dictionary, which physician and medical ethicist Maurice Pappworth alleged was the source of Asher's "accidental" reputation as a medical etymologist.[7] They had three children: Peter Asher (born 1944), a member of the pop duo Peter & Gordon and later record producer, Jane Asher (born 1946), a film and TV actress and novelist, and Clare Asher (born 1948), a radio actress.

The Asher family home above his private consulting rooms at 57 Wimpole Street was briefly notable when Paul McCartney lived there in 1964-1966 during his relationship with Jane Asher.[8]

In 1964 Asher suddenly gave up his hospital post and perhaps all medical activities.[4] He suffered from depression in later life and reportedly died by his own hand at the age of 57.[3]

Ideas and reputation[edit]

Asher was regarded as "one of the foremost medical thinkers of our times",[9] who emphasised the need "to be increasingly critical of our own and other people's thinking".[10] Asher was particularly concerned that "many clinical notions are accepted because they are comforting rather than because there is any evidence to support them".[11]

Asher was hailed as a pioneer[12] in challenging the value of excessive bed rest following treatment,[13] and argued that the Pel-Ebstein fever (a fever characteristic for Hodgkin's disease) was an example of a condition that exists only because it has a name.[14] Asher's 1949 paper "Myxoedematous Madness"[15] alerted a generation of physicians to the interaction between the brain and the thyroid gland. As a result, young and elderly psychiatric patients are now screened for thyroid malfunction.[16] Some of the 'madness' cases are now thought[17] to be the early descriptions of Hashimoto's encephalopathy, a rare neuroendocrine syndrome sometimes presenting with psychosis.

Notable articles[edit]

Asher is remembered today mostly for his "refreshingly provoking"[3] articles which "sparkle with sequins--his own aphorisms, imaginary dialogue, fantasies, quotations."[18] He thought that medical writing should provide "useful, understandable, and practical knowledge instead of allotov-words-2-obscure-4-any-1,2-succidin-understanding-them."[19] Anthologies of his articles were well-received,[9][20] with the Talking Sense collection being described as "still the best advice on medical writing."[21] Notable articles include:

"Seven Sins of Medicine"[edit]

The "Seven Sins of Medicine"[3] is a lecture delivered by Asher and later published in The Lancet, describing medical professional behaviour that is considered inappropriate. These sins are often quoted to students:

  1. Obscurity
  2. Cruelty
  3. Bad manners
  4. Over-specialisation
  5. Love of the rare
  6. Common stupidity
  7. Sloth

Prize in his memory[edit]

Since 1995 an annual prize (2010 value £1,200) in memory of Asher has been awarded by the Royal Society of Medicine and the Society of Authors for the best first edition textbook aimed at undergraduate students.[23] The most recent prize was presented to Hugo Farne, Edward Norris-Cervetto and James Warbrick-Smith for their book "Oxford Cases in Medicine and Surgery" at the Royal Society of Medicine, 27th of October 2010.

References[edit]

  1. ^ GRO Register of Births: JUN 1912 2b 394 BRIGHTON - Richard Asher, mmn = Stern
  2. ^ GRO Register of Deaths: JUN 1969 5d 1959 ST MARYLEBONE - Richard Asher, DoB = 3 Apr 1912
  3. ^ a b c d e Rowat, Bruce M.T. (1985). "Richard Asher and the Seven Sins of Medicine". Humane Health Care (Volume 1, Number 2). Retrieved 2008-03-20. 
  4. ^ a b Anonymous (1969-05-10). "R. A. J. Asher (Obituary notice)". British Medical Journal 2 (5653): 388–388. doi:10.1136/bmj.2.665.388. PMC 1983233. 
  5. ^ Asher R (1951). "Munchausen's syndrome". Lancet 1 (6650): 339–41. PMID 14805062. 
  6. ^ GRO Register of Marriages: September 1943 1b 4 Pancras - Asher = Eliot
  7. ^ Lock, Stephen (2003). "The words of medicine, R. Fortuine (book review)". Med Hist 47 (1): 139. PMC 1044791. 
  8. ^ Vickers, Graham (2001). Rock Music Landmarks of London. Omnibus Press. ISBN 0-7119-8675-4. 
  9. ^ a b Drew, Robert (1973). "Richard Asher Talking Sense by Francis Avery Jones (review)". Proc R Soc Med 66 (5): 488. PMC 1644921. 
  10. ^ Asher, Richard (1954). "Straight and Crooked Thinking". Br Med J 2 (4885): 460–462. doi:10.1136/bmj.2.4885.460. PMC 2078909. PMID 13182247. 
  11. ^ Talking Sense quoted in Asher R (1999). "Endpiece". Br Medical J 2 (4885): 1532. PMC 1115904. PMID 10356012. 
  12. ^ Sharpe M, Wessely S (1998). "Putting the rest cure to rest--again". BMJ 316 (7134): 796–800. doi:10.1136/bmj.316.7134.796. PMC 1112768. PMID 9549447. 
  13. ^ Asher, Richard (1947). "Dangers of Going to Bed". Br Med J 2 (4536): 967–968. doi:10.1136/bmj.2.4536.967. PMC 2056244. PMID 18897489. 
  14. ^ Hilson AJW, DiNubile MJ (1995). "Pel-Ebstein fever". N Engl J Med 333 (1): 66–67. doi:10.1056/NEJM199507063330118. PMID 7777006.  They cite Asher's lecture Making Sense (Lancet 1959;2:359)
  15. ^ Asher R (1949). "Myxoedematous madness". Br Med J 2 (4627): 555–562. doi:10.1136/bmj.2.4627.555. PMC 2051123. PMID 18148089. 
  16. ^ Kiraly, Stephen; Ancill, Raymond; Dimitrova, Gergana (May 1997). "The Relationship of Endogenous Cortisol to Psychiatric Disorder: A Review" (PDF). Canadian Journal of Psychiatry 42 (4): 415–20. PMID 9161767. Retrieved 2008-03-20. 
  17. ^ Garrard P, Hodges JR, De Vries PJ, Hunt N, Crawford A, Hodges JR, Balan K (January 2000). "Hashimoto's encephalopathy presenting as "myxodematous madness"". J. Neurol. Neurosurg. Psychiatr. 68 (1): 102–103. doi:10.1136/jnnp.68.1.102. PMC 1760600. PMID 10671115. 
  18. ^ Ruth Holland's introduction to A Sense of Asher, quoted in "From a flea's teeshirt". British Medical Journal 313 (7072): 1654–1656. 1999-12-21. doi:10.1136/bmj.313.7072.1654. Retrieved 2008-03-20. 
  19. ^ Asher, Richard; Wright, MD (1947-11-15). "All the Vitamins". British Medical Journal 2 (4532): 788–788. doi:10.1136/bmj.2.3278.788. PMC 2056092. PMID 20340806. 
  20. ^ Greene, Raymond (1972-11-04). "Wit and Wisdom". British Medical Journal 4 (5835): 306–306. doi:10.1136/bmj.4.5835.306-a. Retrieved 2008-03-20. 
  21. ^ Kay, H.E.M. (May 1, 1983). "How to Write and Publish Papers in the Medical Sciences (review)". Journal of Clinical Pathology 56 (5): 607. PMC 498301. 
  22. ^ Dr James Le Fanu (2004). "In sickness and in health". Daily Telegraph. Retrieved 2008-03-20. 
  23. ^ "Medical Books Awards". The Society of Authors. 2008. Retrieved 2008-12-10. [dead link]