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Biographical entry Keynes, Sir Geoffrey Langdon (1887 - 1982)

Kt 1955; MRCS 1913; FRCS 1920; BA Cambridge 1909; MA 1915; MB BCh 1915; MD 1918; FRCOG 1950; FRCP 1953; Hon LLD Edinburgh; DLit Oxford; DLitt Sheffield, Birmingham & Reading; LRCP 1913.

Born
25 March 1887
Cambridge
Died
5 July 1982
Occupation
General surgeon

Details

Geoffrey Langdon Keynes was born at Harvey Rd, Cambridge, on 25 March 1887, the third child and second son of Dr John Neville Keynes, ScD, the registrar of Cambridge University, and of Florence Ada Keynes, a daughter of Dr John Brown, pastor of the Bunyan (Congregational) Meeting in Bedford. Geoffrey's elder brother, Maynard, was later the distinguished economist, Lord Keynes. Though differing in temperament and intellect the brothers shared a passion for book collecting. They were nephews of Sir Walter Langdon Brown, Regius Professor of Physic at Cambridge and consultant physician to St Bartholomew's Hospital, and great nephews of Dr Langdon Down whose name is now associated with mongolism.

After early education at St Faith's Preparatory School, Cambridge, and at Rugby School, where he was a close friend of Rupert Brooke, in whose father's house they both were, he was a foundation scholar to Pembroke College and secured a first-class in the Natural Science Tripos in 1909 and an open scholarship to St Bartholomew's Hospital in 1910. At Bart's he won the Wix Prize for his essay on Sir Astley Cooper, and also the Brackenbury Surgical Scholarship and the Willett Medal for operative surgery. On qualifying in 1913 he was house surgeon to Sir Holburt Waring and joined the RAMC in 1914 on the outbreak of war, later achieving the rank of Major as a surgical specialist with the British Expeditionary Force in France, and being mentioned in dispatches. During that war he undertook important work on blood transfusion, devising the Keynes blood flask, and writing several papers and a monograph on this subject.

Keynes completed his MD in 1918 and the Final FRCS in 1920 when he was appointed as first assistant to the new professorial unit under the whole-time directorship of George Gask. He there came under the influence of Sir Thomas Dunhill, associate surgeon to that unit, and later expressed his indebtedness to both these mentors. During this period he was also private assistant to Lord Moynihan in his London practice and undertook much of his important research on carcinoma of the breast. Professor Gask had encouraged him to investigate the use of the then newly acquired radium for the treatment of locally recurrent disease. So impressed was Keynes with the results that he extended the treatment to patients with advanced primary cancer, and later to those with operable disease, for he was gravely dissatisfied with the results of radical surgery which he shortly abandoned. In a succession of papers between 1927 and 1937 he recorded his experience with conservative surgery and irradiation. Prior to this work on the conservative treatment of breast cancer he had researched on cystic disease of the breast which was the subject of his first Hunterian lecture in 1923.

He became assistant surgeon at Bart's in 1930, aged 43, but already had appointments at Mount Vernon Hospital, the Radium Institute, the London County Council Thyroid Clinic at New End Hospital and the City of London Truss Society, all of which widened his field of surgical interest. He published papers on the operative treatment of large hernias. In thyroid surgery he carried on the teaching and example of Dunhill, and published a number of papers, some with his physician colleague, Dr Linnell, at New End. Much of his large private practice was concerned with breast cancer and thyroid disease, and he generally charged quite small fees for, as he would often say, 'many of my patients were middle class folk of modest means'.

On the outbreak of the second world war he was 52 years of age and still an assistant surgeon at Bart's, but he did not hesitate to volunteer for the Royal Air Force Medical Service in which he served until 1945 with the eventual rank of Acting Air Vice Marshal. Demobilised at the age of 59, to become full surgeon at Bart's, he only had one year left before the pre-NHS retiring age of 60. However, he was then given the title of emeritus surgeon with half a dozen beds for the next five years. In that shrunken allotment he achieved his last surgical breakthrough as the first surgeon in the UK to undertake thymectomy for the previously incurable myasthenia gravis. The operation, having been performed by Blalock a year before in Baltimore, USA, was abandoned there in the belief that it was valueless. Geoffrey and some of his neurologist colleagues were criticised for their persistence; but, yet again, his courage in pioneering a controversial method of treatment was eventually fully justified.

Geoffrey Keynes' second period of war service, and his unselfish sacrifice of his personal interests, led to his relatively late election to Council of the Royal College of Surgeons on which he served with diligence and enjoyment from 1944 to 1952. He declined to stand for a second term for, as he said, 'I was afraid that I might become President'! He had given two further Hunterian lectures in 1929 and 1945, and was later appointed Thomas Vicary Lecturer in 1948, when he spoke on The portraiture of William Harvey; Cecil Joll Lecturer and gold medallist in 1953 and Moynihan Centenary Lecturer in 1965. The iconography of William Harvey led on to a full-length biography (1966) which won him the James Tait Black Memorial Prize. He was also honorary librarian of the Royal College of Surgeons and a Hunterian Trustee, and was awarded the College Gold Medal in 1969. He gave the Blair Bell Lecture at the Royal College of Obstetricians and Gynaecologists and was elected FRCOG in 1950. At the Royal College of Physicians he was Harveian Orator, Fitzpatrick Lecturer and Osler Orator and gold medallist and was elected FRCP in 1953. He received the accolade of Knight Bachelor in 1955, a somewhat belated recognition of his outstanding distinction and achievements. The following year, aged 69, accompanied by his wife, he set off as Sir Arthur Sims Travelling Professor to lecture in Canada and Africa.

Few surgeons have achieved such outstanding distinction both within and outside their profession. He was an avid bibliophile who started book collecting as a schoolboy and formed the Baskerville Club while at Cambridge. Like Osler he blended medical skill of the first order with a passion for literature and the arts. His personal library, in his chosen fields, was second to none, notably in his matchless collection of Thomas Browne, Evelyn, Hooke and Ray with more than respectable holdings of Blake, Jane Austen and Hazlitt. In 1975 he gave some 250 works concerning Sir Thomas Browne to the Library of the Royal College of Physicians. He also had superlative collections of the works of his close friends, Rupert Brooke and Siegfried Sassoon. Each of these collections contributed towards an impressive row of author-bibliographies. That of John Donne, the first of which appeared in 1914, set a pattern in which physical description of the volumes was interwoven with background and biographical material. The result, readable and elegant, introduced a wide circle of cultivated readers to a subject in which imagination and narrative formerly had little place. His bibliography of John Evelyn, 1937, has been cited as the happiest example of Keynes' method over half a century which, in his presidential address to the Bibliographical Society in 1953, he defended as his 'latitudinarian approach'. His first bibliography of John Donne was published while he was still a student and whilst he was already at work on his study of William Blake, whose poems, songs and illustrations remained of absorbing lifelong interest. He instigated the William Blake Trust in 1949 and was its Chairman until his death.

Blake may well have fired his interest in book design and the visual arts. He helped his friend Francis Meynell with the design of no less than 16 Nonesuch Press books. He inspired the ballet Job; a masque for dancing, for which his sister-in-law Gwen Raverat composed the designs and Vaughan Williams the music, to be staged by Ninette de Valois in 1931. He was a friend and early patron of Eric Gill and had the best collection of Stephen Gooden's work. He was appointed a trustee of the National Portrait Gallery in 1942, and was its Chairman from 1958 to 1966.

Though outwardly austere and generally less formally dressed than his practising colleagues, he was a strikingly handsome man of tireless energy, intolerant of the second-rate, but with a wide circle of friends many of whom were contemporary with his children and grandchildren. His operative work had been characterised by an outstanding manual dexterity which he carried into his retirement with his fine wood-carving and brick-laying at Lammas House, Brinkley, where he gardened and planted trees whilst continuing his absorbing literary interests. In 1917 he married Margaret Elizabeth Darwin, daughter of Sir George Darwin, KCB, FRS, and grand-daughter of Charles Darwin. Her fascinating book on Newnham Grange (now Darwin College, Cambridge), A house by the river, was published in 1976, just after her death. His own autobiography, The gates of memory, followed in 1981 when he was already aged 94, and he lived a very active life for a further year, dying suddenly on 5 July 1982. He was survived by his four sons: the eldest, Richard Keynes, FRS, is Professor of Physiology at Cambridge, and the third son is Milo Keynes, FRCS. A service of thanksgiving for Sir Geoffrey's life and work was held in the Priory Church of St Bartholomew-the-Great on 15 November 1982 with addresses by Sir Reginald Morley and Mr John Sparrow.

Sources used to compile this entry: [Brit med J 1982, 285, 299 and 384; Lancet, 1982, 2, 168; The Times 6 July 1982].

The Royal College of Surgeons of England