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Biographical entry Hopewell, John Prince (1920 - 2015)

MRCS LRCP 1943; MB BS London 1943; FRCS 1950.

Born
1 December 1920
London
Died
14 January 2015
Occupation
General surgeon, Transplant surgeon and Urological surgeon

Details

John Prince Hopewell, a consultant urological surgeon at the Royal Free Hospital, London, was a pioneer in the introduction of dialysis into the UK and the development of kidney transplantation. He was born on 1 December 1920, the fourth child and only son of Samuel Hopewell and Wilhelmina ('Daisy') Hopewell née Edwards. His father was a south London general practitioner who had come to London in order to study medicine from the island of St Helena. In later life John Hopewell was able to trace the history of the family by reference to his family Bible, a second edition (1540) of the Great Bible published for the first time in English under the direction of Henry VIII.

Until the early 18th century the family had been textile workers in Nottinghamshire, but with the Industrial Revolution overseas trade opened up new possibilities and in 1813 a family member, Richard Prince, was dispatched to St Helena, ostensibly to collect an outstanding debt. Realising the trading potential of the island in the days of sail, he stayed and established a chandlery business which flourished for three generations. Thereafter all male offspring of the family continued to incorporate the name Prince. The coming of steam ships and the opening of the Suez Canal caused a diminution in trade, something that may have encouraged the family to support his father in seeking a medical education at the London Hospital, eventually settling in family practice in Brixton, where John was born.

He had a happy childhood and from a prep school in Dulwich won an exhibition to Bradfield College, where he continued to succeed academically. Although lightly built and not, by his own reckoning, good at ball games, he succeeded in representing his school in fencing and cross country running. During those years he developed a puckish sense of humour (he was cast as Puck in the school play) and this amiable quality stayed with him throughout his long life.

In 1938 he won a place to study medicine at King's College Hospital, the preclinical school of which was evacuated to Glasgow in the early years of the war. He qualified in 1943 and was appointed to surgical house jobs at King's and Horton, where he dealt with Londoners injured in bombing raids and then, in large numbers, the casualties from the Normandy landings. He was called up in 1945, serving in the RAMC in India, latterly as a captain who was sometimes the sole surgeon in isolated hospitals in Cochin and Deolali in the south of the country.

He returned to King's in 1948 as a surgical registrar, working again for the orthopaedic surgeon H L C Wood, whose house surgeon he had been and who became a role model for his future professional career. During this time he also worked for J G Yates Bell, who stimulated his interest in urological surgery and took an interest in his future training. He qualified FRCS in 1950 and after a period of research at the Buxton Browne Farm at Downe, which resulted in him giving a Hunterian Lecture at the Royal College of Surgeons, he was appointed as a senior registrar in 1955 on a rotation between King's and Brighton.

During the winter of 1955 to 1956 Yates Bell arranged for him a secondment to a leading urological department in San Francisco. It was there, at Stanford, that he first saw haemodialysis in action, where patients with polycystic renal disease were being dialysed with beneficial success, something which helped to influence the course of his future career.

In 1957 he was appointed as a consultant surgeon at the Royal Free Hospital with the intention of setting up a department of urology, his vision being also to establish a programme for the treatment of end stage renal failure by maintenance dialysis and renal transplantation. At that time dialysis was being used only for acute renal failure and renal transplantation was also in its infancy.

He persuaded the hospital to purchase one of the first dialysis machines from America in 1958 and, with the help of newly appointed medical colleagues, the first maintenance dialysis service in the UK was started in 1961.

Shortly after he was appointed at the Royal Free, Roy Calne joined as a registrar and expressed an interest in researching methods of controlling the rejection response. John Hopewell encouraged him to do so and arranged animal research facilities for him at Downe. Calne's success with 6-mercaptopurine was thought sufficiently convincing for the team to feel justified in embarking on a trial of human renal transplantation. Three transplants were performed between 1959 and 1960. The first two grafts from cadaveric donors failed to function, but the third, taken from a live donor (the recipient's father) functioned for seven weeks before the patient's death from miliary tuberculosis, thought to have emanated from the donor kidney. It was, nevertheless, the first British live donor, non-sibling kidney transplant using an immunosuppressant that had been shown to be effective in animal trials.

At first the success of maintenance dialysis persuaded Hopewell to take the decision to delay the further use of renal transplantation until 1968, by which time Calne, working in America, had modified and improved the immunosuppression regime with the introduction of azathioprine. Meanwhile at home the team had been expanded by an accumulation of clinical and laboratory experts and the appointment of A N Fernando as an assisting consultant transplant surgeon. The subsequent success of the transplant programme at the Royal Free was helped by Hopewell's meticulous surgical technique and acute surgical judgement, attributes that led to him having an extensive surgical practice, attracting referrals from colleagues throughout the United Kingdom and overseas.

In the wider world of medicine he banded together the centres in London interested in developing renal transplantation to form the London Transplant Group and was instrumental in joining them with the British Society for Immunology to form the British Transplantation Society in 1972, when he was elected as its first treasurer. He was president of the Fellowship of Postgraduate Medicine, of the section of urology of the Royal Society of Medicine and of the Chelsea Clinical Society. Quietly formidable in committee, he was elected as chairman of the Hampstead District Health Authority, of the medical committee of the Royal Free, of the Camden District medical committee and the medical committee of the Hospital of St John and St Elizabeth. He was a member of the Court of Examiners of the Royal College of Surgeons from 1969 to 1975 and was elected as an honorary member of the New York section of the American Urological Association.

In 1959 John Hopewell had married Natalie Bogdan, a Russian émigré who had won a scholarship to come to Britain to study medicine at the Royal Free. They met when she was appointed as a houseman on the surgical firm that he shared with George Qvist. During a very happy marriage they subsequently had a daughter, Valentina Ellen, and a son, Richard Alexei Prince, the latter being tragically killed in a car crash in 2008.

In 1974 the Royal Free had just moved from the Gray's Inn Road to its present site in Hampstead, when his life took a sad and dramatic turn as Natalie was diagnosed as having metastatic cancer. She died in the following year at the age of 41.

He eventually retired from the Royal Free in 1986. Two years before that he had married again, his second wife being Rosemary Radley-Smith, the daughter of the consultant surgeon Eric Radley-Smith who John had worked for as a young house surgeon. Rosemary had also trained at the Royal Free and had become a distinguished paediatric cardiologist, working closely with Magdi Yacoub at Harefield Hospital.

On retirement he and Rosemary sailed to St Helena to research the history of the Hopewell family. He returned again in 1992 when the Foreign Office sent him to work there for a few months as the island's first urological surgeon. He was also can active member of the Lives committee at the Royal College of Surgeons for more than ten years. In 1995 the Hopewells moved to a Victorian vicarage in Langrish, near Petersfield in Hampshire, where they immersed themselves in the life of the community, taking on the editorship of the local paper, The Langrish Squeaker. He became a member of the Society of Ornamental Turners and procured a 19th century turning lathe, which he installed in his home workshop. Thereafter organisations of which he approved often found themselves the recipient of a Hopewell gavel of his own manufacture. He continued to write and in his 90th year produced a history of the treatment of renal failure in the UK by dialysis and transplantation.

A convivial man, he always enjoyed a party and in his retirement was responsible for founding a retired consultants luncheon club at the Royal Free, an equally convivial summer reunion of urological consultants of the past (meeting under the soubriquet of the 'Urohasbeens') and also a popular annual past presidents dinner of the section of urology of the Royal Society of Medicine.

John Hopewell died at home on 14 January 2015 at the age of 94. At a memorial service in the nearby village of East Meon some 250 friends and colleagues assembled to celebrate a man who had not only made a great contribution to the development of renal transplantation, but also had enriched the lives of those who had known him.

Robert Morgan

Sources used to compile this entry: [The Telegraph 12 February 2015 www.telegraph.co.uk/news/obituaries/11408813/John-Hopewell-surgeon-obituary.html - accessed 20 May 2015; The Independent 16 March 2015 www.independent.co.uk/news/people/john-hopewell-pioneering-urologist-who-led-the-way-in-the-treatment-of-kidney-failure-both-by-dialysis-and-transplantation-10111906.html - accessed 20 May 2015; The Times 24 March 2015].

The Royal College of Surgeons of England