In Memoriam: David Bowsher

David R. Bowsher, MD, ScD, PhD, FRCPEd, FRCPath
IASP Honorary Member
Liverpool, UK
1925-2011

David Bowsher was born in Amesbury, Wiltshire, UK, on 23 February 1925, although he was always proud of his mother's Welsh ancestry. David had a conventional education, first at a French-orientated prep school, then at Haileybury College. Here, he won the Tancred Scholarship in Physick to study medicine at Gonville & Caius College, Cambridge. He completed his medical education at University College Hospital London, qualifying in medicine in 1950. After a short trip to Italy, where he met his first wife (Anna) Meryl Reid, he took his first medical job as Gynaecological House Surgeon at St. Mary's Hospital, Manchester. He moved to Liverpool, where Meryl's family (also medical) lived, in March 1951 and spent the rest of his life there. After serving as House Surgeon at the Liverpool Royal Infirmary and the Royal Southern Hospital, he was appointed a Lecturer in the Department of Anatomy in 1953. He taught neurology to generations of undergraduates and supervised, encouraged and often inspired postgraduates. In 1987, several years after becoming Reader in Anatomy, he moved to the Department of Neurological Science and he retired in 1990.

David's early education partly fulfilled the wishes of his father, a Chemical Pathologist, for David to qualify as a physician and enter general practice. But, contrary as always, David followed his own path. He had been brought up with a passion for learning, music and poetry. His family's several moves during his childhood, his education and his travels at home and abroad helped him find the joys of exploration and honed his deep appreciation for language(s). His experiences in Cambridge, where he developed a large lifetime circle of intellectually- engaged and engaging friends expanded even more his love for seeking and acquiring knowledge. These accumulated experiences led David naturally into scientific research; from the beginning of his medical career to his death, he remained enthusiastically involved in the science of medicine.

The 1950s and '60s were heady times for the emerging field of brain science, as the ability to record electrical activity in the nervous system and more sensitive neuroanatomical tracing methods became commonplace. And thus it was natural for David to become one of the early pioneers to use these methods, to great effect, mostly to study pain and, more generally, somatosensation. Between 1953 and 1969, he began his career of extraordinary research productivity. During these 17 years, while working as an experimental neurologist, David published 29 articles, 25 presentation abstracts, 3 book chapters, and two books, one of which, "Introduction to Anatomy and Physiology of the Nervous System," (Blackwell) eventually went into five English editions and was translated into at least four foreign languages. David's research was wide-ranging and articulate, dealing with spinal pathways, reticular brainstem and thalamic function in both humans and non-human animals. The research was notable not only for scientific breakthroughs in basic central pain mechanisms, but also for its international outreach. David published his work not only with his UK colleagues, but also, after spending the year 1954-55, at Harvard as a National Academy of Science/Royal Society Travelling Fellow, with colleagues in the US (e.g., William H. Sweet), and, in later years, in France (e.g., Denise Albe-Fessard and Pierre Angaut), in Norway (e.g., Alf Brodal and Fred Walberg), and Sweden (e.g., Gunnar Grant and Jan Westman). One of us (KJB) first met David in 1968, at a physiology meeting in Washington DC, based on our mutual interest in the thalamus and its somatosensory/pain functions. Notably, how they met is when David startled everyone by leaping over several tables in a very crowded lunchroom to join KJB's group. Later, this behaviour, possibly related to David's schoolboy prowess in tennis, was repeated during visits with David and his second wife Doreen to Wales, as David leaped over fences while Doreen and KJB watched and/or climbed.

Even more admirable, while engaged in all this work, David also managed to obtain his Cambridge M.D. degree in 1960, with the thesis, "Studies on the cerebrospinal fluid," and then a Ph.D. degree in 1961 from the University of Liverpool, with the thesis, "Somaesthetic afferent systems in the brain stem and diencephalons of primates." On top of all that, he and Meryl had a son, Julian, born in 1953 (now an archaeologist, following David's passion for history). Later on, David met and married, in 1969, Doreen Arthur, a member of the senior administrative staff at the University of Liverpool. Doreen and David's marriage and life together in Liverpool proved to be long and happy.

Near the end of this first period of his life, David's special interest in sensory nerve pathways lead him to link up with the Regional Department of Medical and Surgical Neurology which had been established in Walton Hospital in Liverpool in 1947, and in which interesting clinical work was being developed in the area of chronic pain due to advanced cancer by Dr. Sampson Lipton. Together with Dr. Peter Buxton, David and Sam produced studies of human spinal cord lesions, correlated with the sensory deficit achieved by percutaneous cordotomy, studies that have never been bettered.

In 1971, one of us (JBM) was appointed Consultant Neurosurgeon, and, having had training in surgical procedures to relieve pain, was immediately roped into the rapidly expanding group interested in managing chronic pain in Walton Hospital. Publications on many different pain- relieving techniques resulted, including those on acupuncture, implanted stimulators, and pituitary destruction. It soon became obvious that research funding would be necessary if proper exploration of the many different techniques was to be undertaken. While existing major funding sources were not responsive to funding research into what might be considered simply a symptom rather than a disease process, it was decided to seek direct funding, resulting in the establishment of the Pain Relief Foundation (PRF) in 1979.

The aims of the PRF were to be in the areas of education, research and training. David contributed greatly to each of these. He was a prolific writer and commonly led the group into publications. In research, he again commonly led in seeking external funding, but also he had that characteristic, essential for any successful research worker, of persistence and determination to complete studies, whatever the apparent criticism or odds against likelihood of success. His work on pain in shingles, based as it was in the community, has had a profound effect in the improvement of immediate treatment. His advocacy of the importance of quantitative sensory testing of patients in many different chronic pain syndromes, as a means of discriminating between them, and, as a result, affecting both diagnosis and sometimes treatment, has been an example to many. This contribution was particularly important in studies that were undertaken to prove that, in most patients with trigeminal neuralgia, the effect of compression of the nerve at the root entry zone included a detectable sensory deficit, and that decompression could result in not only pain relief but also measurable improvement in sensory function.

David's best contribution, however, was in the area of training. His massive publication portfolio of ~300 papers in reputable journals, innumerable chapters in books and more than 150 invited lectures, gained him world renown and resulted in most people interested in pain seeking to visit the PRF. Such visits could be for conferences, or to attend or work at the PRF for days to years. And when visitors were there, David was their father figure, being kind, patient and extremely generous spirited with his helping them in their clinical or research training, degree completion, and publishing. This pattern continued even after his retirement from Director of Research at the PRF in 2000.

David had one awkward characteristic. He was intolerant of inefficiency or small inequities (to him) in others, and his comments were fierce. For example, he was an expert driver and the stupidity of other drivers and road users frequently led to verbal fury, which caused a certain unease in his passengers. But this kind of outburst could also be directed at many others, particularly colleagues and friends, including both of us. Of particular focus was the use of the English language, where apparent (to him) grammatical errors or misspellings could trigger no-holds-barred indignation. One of us (JBM) personally found it effective to be equally direct back to David; KJB simply ignored it until it subsided, which usually worked.

This characteristic was, however, outweighed by an essential part of David, enjoyed and appreciated by all who knew him: his unfailing sense of humour and his wit. On social occasions, his presence ensured laughter. David peppered every type of communication with humour and caustic commentary, sometimes at his own expense. As examples: in explaining to one of us (KJB) his treatment for two episodes of epistaxes (nosebleeds), he said, "Soldering irons were inserted into my locally-anaesthetised nostrils." In describing his recovery from a fall, he said, "My arm IS getting better and I have some more movement; and the pain is less, except when Doreen's around." He seemed constitutionally unable to carry out any exchange without such wit, a wit that made many conversations with him challenging, provocative and fun.
 
David was awarded honours throughout his life, including the Abel Salazar Medal from the University of Oporto, Portugal; the Platinum Medal, from Nihon University in Tokyo; and honorary membership in the British Pain Society and IASP. He became president of several scientific and medical organizations, as well as, from 1987 to his death, the Burke and Hare Society , which befitted David's early career as an anatomist. As further tribute, this time to David's lifelong, successful, and generous career in Liverpool, last year he received the Citizen of Honour award from the City of Liverpool, which said "in recognition of being the co-founder of Pain Relief Foundation and for his services to the community in the area of pain relief."

David is survived by his wife, Doreen, now retired from her own career, his son Julian, daughter in law Tuula and granddaughter Anna.

David died peacefully in Liverpool, U.K. on 17th June 2011. He created many memories for those who knew him - lively, unusual and often very funny - and these will live on.

Karen J. Berkley, PhD, and John B. Miles, MB, BCh, FRCS