Leading authority on cot deaths

Prof John Emery who died on May 1st aged 84, was a distinguished paediatric pathologist and one of Britain's leading authorities…

Prof John Emery who died on May 1st aged 84, was a distinguished paediatric pathologist and one of Britain's leading authorities on cot death.

The first son of a village schoolmaster at Aylburton, Gloucestershire, on the edge of the Forest of Dean, he was educated at Lydney grammar school, qualified at Bristol University in 1939, and soon began his career in children's medicine at Bristol children's hospital. After the hospital was damaged by war-time bombing, he was in charge for a while when it was evacuated to Weston-Super-Mare.

At that time, trainee paediatricians in Britain spent a year in pathology - this is no longer the case - and he became pathologist in charge of the evacuated hospital laboratories of the Bristol University teaching hospitals. In 1947, he was appointed consultant pathologist to the Sheffield children's hospital, where he was to remain for the rest of his professional life. He was appointed professor associate by the University of Sheffield in 1972 and retired as emeritus professor in 1980.

In his early work at Sheffield, he published prolifically on lung development in infancy, malformations, spina bifida, children's tumours and tuberculosis. Perhaps motivated by the loss of one of his own children at an early age, he focused his attention on sudden, unexpected death in infancy.

READ MORE

Writing in 1989, he said: "As infant mortality diminished in the first half of this century, more attention was given to those babies dying unexpectedly and with less florid disease. The skills required to study such deaths had not, however, been developed, and the result was that diagnoses ranged from pneumonitis to suffocation. The latter label led to parents being interrogated by the police and to social stigma. In 1969, a group in Seattle, believing that all of these were natural deaths, recommended that they should be registered as the sudden infant death syndrome (SIDS)."

John Emery, however, described the label as a seductive diagnosis, which excused all concerned from any defect in care, diagnosis and treatment. He regarded SIDS not as a single entity, but as the result of many different causes. He reported that after meticulous post-mortem examination and detailed confidential inquiry, only 17 per cent of deaths diagnosed as SIDS remained completely unexplained.

Unlike those pathologists who remain glued to their microscopes, he instigated measures in the community to reduce the toll of cot deaths. An early member of the Foundation for the Study of Infant Deaths, he became director of the Coni (Care of Next Infant) programme.

By identifying babies at risk, establishing a selectively intensive health-visitor programme and responding promptly to those early symptoms which may presage cot death in vulnerable babies, he and his colleagues in Sheffield achieved a substantial fall in infant death rate. He travelled and lectured widely. At the invitation of the White House, he carried out a survey in 1975 of the cot death bereavement community service in seven US states. In 1986, he made a study of the primary childcare services in New Zealand for the minister of health and the Plunket Society of New Zealand. This was followed by a national research survey, which produced information leading to the back-to-sleep campaign that halved cot deaths in New Zealand.

He consistently argued that paediatric pathology was a discipline distinct from its adult counterpart. As a founder member of the Paediatric Pathology Society, the International Paediatric Pathology Association (IPPA) and several other learned societies, he promoted international debate and research. He was keen to attract and train bright recruits, organising with Johannes Huber the first five annual advanced international training courses in paediatric pathology on behalf of the IPPA.

He had a sparkling intellect, a roguish wit and an artist's eye and hand. At a scientific meeting, he might be seen busily sketching the speaker, an activity which in no way impaired his ability to ask the penetrating question. A gifted orator, he had the ability to hold an international audience spellbound, as he did at the end of a long meeting to honour his own 80th birthday, when he spoke about occupational disease in neolithic man.

In Sheffield, he had been president of the Fine Arts Society, the Literary and Poetry Society and the Sheffield Museum Society. His interests in history, decorated cast iron, prehistoric art and art symbolism were shared with his wife, Mytts.

To his colleagues, he was the father of paediatric pathology in Britain. To his friends, he was a gentle, witty and knowledgeable raconteur. He received many academic honours, including an honorary degree from the University of Sheffield in 1999.

John Emery is survived by his wife, four sons and two daughters.

Prof John Lewis Emery: born 1915; died May, 2000