One Man’s Medicine An Autobiography of Professor Archie Cochrane ARCHIBALD L COCHRANE with MAX BLYTHE Publishing history This edition is released to the Internet CC BY-NC-ND 4.0 2.2.2 Contents Cochrane Colloquium edition acknowledgements 1 The tens and twenties 2 The thirties 3 The forties 4 The fifties 5 The sixties 6 Into the seventies 7 Into the eighties Appendix A - AL Cochrane (1909-88) biographical outline Appendix B - AL Cochrane’s principal publications Appendix C - The prehistory of the first Cochrane Centre and inauguration of the Cochrane Collaboration by Sir Iain Chalmers. 1989 First Edition Acknowledgements Gratefully acknowledged is the assistance of many of Archie Cochrane’s colleagues and friends during the completion of this text after his death. Their critical observations on various chapters of the biography and addition of data to Archie’s sparkling, initial drafting of the work have enhanced its authenticity. Major contributors include Professors Charles Fletcher, Ian Higgins, Stewart Kilpatrick, Estlin Waters, Hubert Campbell, Peter Oldham, Richard Schilling, George Knox, Guy Scadding, Alan Williams, Archibald Duncan, Ken Rawnsley and Bryan Hibbard; Drs John Gilson, Bill Miall, Reginald Saxton, Peter Elwood, Max Wilson, Philip Hugh-Jones, Julian Tudor Hart, Jean Weddel, Neville Willmer, Joyce Landsman, Richard Mayon-White, Wilfrid Harding, Jeffrey Chapman and David Bainton, also Mr Fred Moore, Mr Peter Sweetnam, Miss Irene Calford and Mr Peter Nicholas. Artist Derek Whiteley supplied maps and charts. Special thanks to Sir Richard Doll and Dr Dick Cohen for introductory observations, and to Archie’s family, particularly Helen, Joe and Maggie Stalker for supportive kindness. Max Blythe 2.2. 4 One Man’s Medicine An Autobiography of Professor Archie Cochrane 1 The tens and the twenties EARLY DAYS I was born on 12 January 1909 in Galashiels, a small town in the south of Scotland. (I would like to believe that I was conceived in Bamburgh, a lovely village on the Northumbrian coast, and there is some evidence to support the idea.) My background was industrial upper middle class. In spite of brief encounters with Evelyn Waugh and George Orwell, who had different views in different directions, I have never tried to conceal or change this. My father’s family was industrial. My grandfather and great- grandfather became wealthy through textile manufacturing. They made Scotch tweeds. My father was a very successful managing director of his father’s business. He was killed in the First World War at the Battle of Gaza when I was too young to know him well, but he was described in his obituary as “of sterling character, kind hearted and fair minded and he had the saving grace of human and genuine friendship.” The Cochrane family was the wealthiest family and the biggest employer in the small town. My grandfather, to establish his position, built a large house, Abbotshill, overlooking Sir Walter Scott’s Abbotsford on the other side of the Tweed. He had a wonderful garden in which we often played as children. It was the origin of my lifelong interest in gardening. 2.2. 6 My mother’s family was different. Both her father and grandfather were lawyers in a neighbouring town, Hawick. My mother was educated at a rather snob school, St Leonard’s School at St Andrews, and later in Paris. She painted, and played hockey for Scotland, but gave up both activities when she married. Her family is examined in detail for another reason in chapter 5. I have searched in vain for any sign of a scientist in my family. The only trace I could find is Lord Archibald Cochrane, ninth Earl of Dundonald, who was a first rate amateur scientist, a friendly rival of Watt, Cavendish, and Priestley. There is a suggestion that we were descended from some branch of that family - probably illegitimately. (I was strongly reminded of this possibility when I visited Jamaica in the 1960s. The beautiful black Jamaican girl at the desk kept my passport rather a long time and I asked why. She smiled and said, “My name’s Cochrane too.” The tenth Earl Dundonald, the famous admiral, was appointed Commander-in- Chief of the West Indian Station in 1848 and visited Jamaica in 1849. Unfortunately further research on my family in Galashiels made this hypothesis rather improbable.) I had a happy early childhood. I had one elder sister, Helen, and two younger brothers, Robert and Walter. There were two nurses and three servants, but in spite of this we saw a great deal of our loving parents before the war. We were, I suppose, to some degree spoilt by regular seaside holidays at Easter and in the summer and expensive Christmas and birthday presents, but there was an underlying element of Calvinist discipline. The general atmosphere of the larger family in which we grew up was more definitely Calvinist. The work ethic was installed early and the existence of a clear cut moral code, telling one what was right or wrong, was assumed. There were other minor strands. It was assumed that I would be wealthy when I grew up, but it was always made clear to me that I would have to start at the bottom and work my way up in my grandfather’s business. The need for self sufficiency was stressed. Another minor strand was the need to treat the lower classes with fairness and politeness. The whole doctrine was probably dug in rather deeper when I was prepared for confirmation into the Presbyterian Church by the Reverend Dr Donald (later well known in Canada). I do not remember much about it, but I can guess what he said. I do not know how much influence this early Calvinist background had on my life. I have certainly worked hard most of my life and am still working. I am, I think, rather conscientious, and if adaptability is one aspect of self sufficiency I certainly adapted quicker and better to sudden changes - such as life as a prisoner of war, the Spanish Civil War, and an unexpected presidency - than most people. I ought possibly to be more grateful to Calvin and John Knox than I usually am. Our weekly pocket money was at first only one penny a week, and church attendance was obligatory. Our social contacts were limited at first. I think there were only five families in the town with 2.2. whose children we were allow8e d to play. Later on we met a wider circle of the children of upper middle class families in the surrounding towns. We never met the “County.” We had excellent relations with our servants. I learned to play whist, and later bridge, from our cook Jean and housemaid Grizzle (whom I recently visited just before her 90th birthday). My whole world changed when war was declared in 1914. We were on holiday at Bamburgh at the time. I remember the hurried journey home in my father’s car and a vague memory of my father explaining to my mother that he must join the Army at once, and her tears. I saw little of my father after that. He came back occasionally on leave and all the children were very happy indeed. He was finally posted to Egypt with the King’s Own Scottish Borderers. He came back once, at least, on leave from Egypt. I remember how determined I was to be the first to welcome him and how I dashed downstairs in my dressing gown to hug him. He was killed on 19 April 1917 at the battle of Gaza. I still remember my feeling of desolation and that of my whole family. My family later sent money to Gaza to build a new wing to a hospital there, which contained a memorial to my father and a friend of his who was killed in the same battle - R R M Lumgair (my father was killed trying to rescue Lumgair). Many years later I decided to take my two nieces to see their grandfather’s memorial and grave. I took advice from the Egyptian Embassy beforehand, but everything went wrong. We were arrested at El Arish. I got out of that by a speech in French, saying I was an elderly professor with one foot in the grave making his last visit to his father’s grave. They let us through. We reached Gaza, tired and worried, had a wash and a meal, and then set off for the hospital. I knocked on the door and a lady with a middle-Western American accent eventually opened it. I stated my credentials — medical professor, my family’s contribution to the hospital, and the memorial to my father. There was a curious pause. She looked at me carefully and then, to my utter astonishment, asked me if I was a Christian. I admit I hesitated for a moment. My nieces and I were tired, but I thought the question was so monstrous that I replied that I was agnostic and that I thought the question was irrelevant. The door was slammed in our faces! Later Arab officials forced our entry, but it is clear that Gaza is an inconvenient place for one’s relations to be buried in. I still cannot guess how she diagnosed me. The desolation caused by my father’s death was not only a family affair. Many people in the town and neighbourhood were killed in the same battle, and there was an atmosphere of gloom in the town for a considerable time. I slowly noticed the repercussions of my father’s death. Our own family slowly moved down in the family hierarchy. We were soon the only family in our circle who did not have a car. Another unfortunate possible result of my father’s death was that I started fighting with my brother Robert. I have no idea why. (My psychoanalyst later had many theories, but I was never convinced.) Soon after we had another tragedy. My brother 2.2.1 0 Walter died. In retrospect I am pretty sure he died of tuberculous