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Biographical entry Hall, Michael Henry (1925 - 2014)

BM BCh Oxford 1948; FRCS 1952.

Born
2 April 1925
Peking, China
Died
4 September 2014
Occupation
Urologist

Details

Michael Hall was a consultant urologist at the Forest Groups of Hospitals. He was born on 2 April 1925 in Peking, China. His father qualified in medicine from Durham. Soon after, in 1922, he took up a post at a mission hospital in China, moving with his newly-married wife to Peking. There he stayed until the outbreak of the Second World War, specialising in respiratory medicine and allegedly treating the last Emperor for TB.

Michael was the second of four children. Together with his younger siblings, he grew up in the care of a Chinese amah (or nanny). All four became fluent in Mandarin, a skill he later used when he unexpectedly came to operate with nurses from China who were working in East London.

Aged seven, he was sent to school in England and won a classics scholarship to Chafyn Grove School in Salisbury, Wiltshire, moving later to Bromsgrove School. From there he became an undergraduate at Worcester College, Oxford. For some time in Oxford he shared rooms with Harold Ellis. Working in the anatomy school under Le Gros Clarke, he studied the lumbosacral spines of volunteers to work out the optimal position for the lumbar roll on seats being designed for submariners. His conclusions corresponded exactly with the design of the Victorian armchairs at home!

During his undergraduate years, he developed a duodenal ulcer which resulted in a pyloric stenosis. This he initially treated himself by aspiration, passing a nasogastric tube nightly for a considerable period until persuaded to undergo a Polya gastrectomy aged 24.

After qualifying BM BCh in 1948, Michael continued to train in Oxford and the Hammersmith, moving up through the junior surgical grades, achieving his FRCS in 1952. He met his wife, Anita, then a Swedish au pair, in 1955 when she was admitted to the Radcliffe Infirmary with acute appendicitis on his take. Having removed her appendix, on discharge he gave her his phone number 'in case any of her visiting relatives needed a guide round Oxford'. They married in Sweden in 1957.

In that year he was appointed as a senior registrar to Poole-Wilson in Manchester, where he remained for seven years. During that time, he trained in oncology at the Christie Hospital and became adept at endoscopic prostatectomy using the prostatic cold punch. He was ahead of his time in concluding that urology needed to become a specialty requiring full-time urologists. His refusal to apply for a general surgery with an interest in urology post held back his elevation to consultant, until Whipps Cross in north east London advertised for a full time urologist. He was appointed in 1963.

As a consultant, he brought prostatic punch surgery to London, teaching himself transurethral resection as this superior technique evolved. He maintained a considerable interest in prostatic cancer, working closely in joint clinics with Harold Hope-Stone from the London Hospital.

He published little, but did note in patients with enuresis a higher than expected incidence of spina bifida occulta (SBO), and observed a link between SBO, irritative bladder symptoms and what he termed the 'funnel neck sign'.

This finding of a funnel shaped posterior urethra seen cystoscopically had been described by J B Macalpine (with whom Poole-Wilson had worked) in his presidential address to the urology section of the Royal Society of Medicine and published in their Proceedings of 1934. Macalpine judged this resulted from 'weakness or paralysis of the internal sphincter' secondary to nervous disorders of the bladder. This funnelling could be seen on IVU (intravenous urogram) as a v-shaped pooling of contrast in the posterior urethra.

Enlisting his son to review all the X-rays, IVUs and cystoscopic findings in his patients with and without SBO, the work was presented at the annual meetings of the British Association of Urological Surgeons and the British Association of Clinical Anatomists in 1987. It raised little subsequent academic interest for what, we would now recognise, is the opening of the bladder neck during involuntary detrusor contractions - the unstable bladder - giving rise to symptoms of frequency, urgency, urge incontinence and enuresis. The association of bladder dysfunction and spina bifida occulta is now well accepted.

He held very firm views on aspects of practice. Urethral catheterisation had to be performed with full sterile precautions: masks, sterile gowns and gloves, and full sterile fields. Juniors were not allowed to use catheter introducers. He could be very forceful. On one occasion, during an outbreak of Klebsiella wound infections, he became convinced this was caused by hand to hand transmission of bacteria and ordered the hospital carpenter to remove all toilet doors on the urology ward in an effort to prevent further spread of infection from patients handling contaminated door handles.

For some years he worked with the Regional Health Authority on a variety of projects and was particularly involved with strategic planning, advising the centralisation of services and consequent closure of small satellite hospitals. The closure of his favourite Forest Hospital in Buckhurst Hill contributed to his decision to retire from NHS practice at the age of 63.

After retirement, he and Anita moved to Southwold in Suffolk, to a house next to John Adnams of Adnams Brewery, whose beer he enthusiastically consumed most lunchtimes in the Lord Nelson. He acquired a lathe and the couple took up and became expert furniture restorers, Michael restoring the frames, Anita the upholstery. Having noticed its poor state of repair, they even reupholstered his barber's chair in antelope hide - still in everyday use. Always a keen gardener (after work they would conduct a 'ward round' of the garden), they acquired an allotment. He was delighted when his grandson became a medical student, the fourth generation of Hall males to become doctors. All in all it was a happy and fulfilling retirement.

Michael died peacefully on 4 September 2014. He was 89. He was survived by his wife, Anita, his son Per, a plastic surgeon, and his daughter, Catherine, a senior lecturer and course leader at the London College of Fashion.

Tim Philp

The Royal College of Surgeons of England