OBITUARY

RAPHAEL MARCUS  M.D. Ch.M. F.R.C.S.

Born Liverpool, October 30 1914, died London March 4 2002, aged 87.

CONSULTANT SURGEON whose medical career spanned over sixty years. Only child of immigrant Eastern European parents he grew up in Liverpool within a close extended family with strong commitment to Jewish values.

He entered Liverpool University Medical School in 1930 although he original was enrolled for accountancy and was houseman to Lord Cohen of Birkenhead. He gained his primary surgical fellowship as World War II broke out and volunteered to the Royal Army Medical Corps attaining the rank of acting Lieutenant Colonel. He spent 4 years mainly in Burma in the forgotten army, which when in the chaos of retreat to the Imphal box, the sappers failed to dynamite his concrete operating floor in the jungle and this was latter used by the Japanese for their heavy guns.  He and Colonel Eric Parry provided with ad hoc equipment (the operating light being constructed from polished up jerry cans) a surgical emergency service in which they developed the art of triage, resuscitation and fluid balance.  He treated the Chindits and argued with Colonel Wingate over the condition of his men, who drove off in fury with the book that recorded the operation performed on his men on the bonnet of his car.  He did not hesitate to performed his own post-mortems on the soldiers to find out their cause of death when necessary.  His description of the moral boosting affect of the arrival of Lord Mountbatten who he was introduced to on the front line was fascinating and when Mountbatten was blown away he was deeply moved.  After the war he returned to academic surgery in the University of Liverpool and quickly gained his final fellowship. His research included the initial work on the use of streptomycin to treat tuberculosis of the kidney and was one of the first in the United Kingdom to use dialysis. He was an early pioneer of nuclear medicine with Professor Sir Joseph Rotblat and George Ansell. They developed the use of radioactive isotopes to measure kidney function and radioactive Iodine to treat thyroid cancer. His MD was on the Management of Chronic retention.

From the 1960’s until the death of his co-investigator, Dr James Watt of the Department of pathology of Liverpool University he carried out original research, not only in diverticular disease but also in developing an animal model for inflammatory bowel disease, in which his sons participated, and formed the basis of one of his son’s MD. This animal model is being used world wide for research into ulcerative colitis.  At the time of his death he was writing an adaptation of his metal detector for the post-operative screening of patients for instruments and swabs by using implanted silicone chips into disposable plastic instruments.

In 1953 he was appointed consultant general surgeon at Clatterbridge Hospital.  His work on retention resulted him treating all such conditions as a surgical emergency and would operate

on these patients in the middle of the night rather than catheterise their bladder risking infection. He was a skilled and daring operator and inoventor sought out by Jehovah witnesses to whom he would say Jehovah seems to look after his own.  He never allowed age to be a criteria for surgery, or if the patient were too ill for an anaesthetic, he would if necessary perform an amputation with the leg frozen in ice and had a nurse kick a bucket to hide the noise of the saw from the patient.  However he new when to refer and was never cavalier.  The hardest decision he would say was when not to operate. He developed one of the first day surgery unit in Liverpool in the early sixties. In its heyday, Clatterbridge Hospital was greatly sought after by junior doctors especially those who wished to train in surgery, they accepted his blunt Northern criticism, Liverpool accent and temper which often resulted in them phoning home early in the morning to ask if God had left yet?  He remained there until his retirement from the National Health Service in 1983 but continued in private practice and later as an expert witnesses up to a year ago.  In 1977, he was awarded the Queen’s Silver Jubilee Medal in recognition of his service to medicine.

He died of intractable cardiac failure under the care of the Doctors all of whom he had been involved in training in Liverpool.  He was up to date in all his medical Journals reading them upto the day before he died.

His last words to me were that you must treat the whole patient.

He was predeceased by his wife Hilda in 1985 and is survived by his five children Michelle (Hirschfield),  Samuel (Professor in Gastroenterology) California USA and Norma (Rudnick) in Ra’anana Israel.  Adrian (Radiologist) and Aron in London, and his 15 grandchildren.