John Ledingham was a commanding presence in Oxford medicine for nearly three decades. He was the archetypal general physician not tied to the routines of a medical specialty. This suited his eclecticism, his tendency to fill his in-tray with too many tasks for a day, and his gregarious nature. He could joust with the medical specialists, the surgeons and the scientists too. He loved Oxford, with its clubby social mix, centred for him on New College where he was a Fellow. In 1974 he was appointed to the May Readership in Medicine. He was the ideal wingman for Sir David Weatherall the newly appointed Nuffield Professor of Medicine, a haematologist. This post provided Ledingham with a platform for his broad range of skills and energy allowing him to contribute locally and nationally to the NHS, the Oxford Clinical School, research and education. The University awarded him a Personal Chair in Medicine in 1989. He was so content in Oxford that he politely declined a number of approaches to move elsewhere. This was just as well for he was not temperamentally suited to the ruthless and lonely task of running a big department. He was too kind. EJR Burrough[1] describes him as
“A Percy Blakeney” [2] of the world of medicine. He was the synthesis of the bedside doctor and the scientist; both sometimes fighting simultaneously to gain ascendancy. His natural aristocratic and equally natural common touch did not have to fight; they were joined and presented a united front. He had that rare capacity to be caught up in his patient’s predicament yet professionally to stand aside- clinically to support him in his life and personally to mourn him at his death. He too had a kindly, scandalous repertoire about events and people which showed a fine and often hilarious perspective.”
He was born on the 19th October 1929 in London, son of John and Una (Garvin) Ledingham. His father was a general practitioner and his mother a physician at the Royal Free Hospital. His maternal grandfather was JL Garvin, the editor of the Observer which may be why John was said to have described his dream job as editor of the Guardian. In retirement, he, with Mark Pottle, edited his uncle Gerard Garvin’s 1914-1916 correspondence from the trenches in France with his parents. The book “We hope to get word tomorrow – the Garvin family letters” was published in 2009. Gerard Garvin was killed the day after his father had written that line. John, born 13 years later bore his names. He was educated at Rugby School and was minded to read Classics. During national service as a Second Lieutenant in the Royal Artillery in Hong Kong, he changed his mind, immersed himself in physics, chemistry and biology and switched from Classics to Natural Science prelims at New College Oxford. He graduated BA with 1st Class Honours in Animal Physiology. He was awarded a Blue for hockey in 1954 and went on to captain Scotland in 1957. He was a clinical student at the Middlesex Hospital. After qualifying in 1957 he was awarded the MRCP in 1959 and made a Fellow in 1971. He worked in junior posts at the Middlesex Hospital and was registrar to Sir John Nabarro (diabetes and endocrinology), the Whittington Hospital (neurology), and finally Senior Registrar to Dr RIS Bayliss and Dr F Dudley Hart at the Westminster Hospital from 1962-4. This firm exposed him to endocrinology and rheumatology and, as was the custom, general medicine. He had flirted with neurology but chose to pursue his undergraduate interest in the kidney stimulated by reading Homer Smith’s Comparative Physiology of the Mammalian Kidney. He learnt the technique of renal biopsy from Dr Jo Joekes. He obtained a research fellowship at Presbyterian Hospital, Columbia University, New York City in 1965-1966 where he worked with Dr John Laragh on the role of the renin-angiotensin system in hypertension. Having failed to be appointed to a consultant post at the Middlesex he was invited to apply for one of two new posts in general medicine, endocrinology, diabetes, metabolic medicine and nephrology in the United Oxford Hospitals. He and Dr Derek Hockaday were appointed, and John became part of the Lee, Ledingham, Juel-Jensen firm on the insalubrious WW2 hutted wards, Rowney and Alexandra, at the Radcliffe Infirmary.
He was first a clinician – he relished his outpatient clinics, on-take and referrals from colleagues. He made patients feel special by listening and promising to seek a solution. He was loyal to them and they were devoted to him. His registrars tired of being asked, “But where is Dr Ledingham?”. His career was packed with roles, tasks and interests. His charm, enthusiasm and fluency led to an array of invitations to do and serve and he found saying 'No' difficult. His unrealistic schedules often made him late for starts but he always apologised, blaming something unexpected or someone who had been too prolix. We suspected that he may have been referring to himself. He made a major contribution to the expansion and reputation of the Oxford Clinical School which enjoyed a golden age after the appointment by Sir George Pickering and later Sir Richard Doll (the Regius Professors) of a number of academic clinicians. He was twice the Director of Clinical Studies – the benign shepherd of a generation of medical students who modelled themselves on his clinical method and were stimulated by his style of teaching – challenging dogma and encouraging enquiry. He was a fair and gentle BM examiner and was delighted when the Ledingham Prize was created to recognise the best Finals student in clinical medicine. In 2011 the University awarded him the title of Distinguished Friend of Oxford.
With Dr Desmond Oliver he had started the Oxford Renal Unit in 1967. This required that the consultants set up the dialysis machines. Early on they had to seek the help of a patient who had learned at the Royal Free Hospital how to dialyse at home. While Oliver was mastering the technical challenges, Ledingham turned his attention to the horrible complications of renal failure – recruiting John Kanis, Michael Bishop and Robert Henderson to work on renal osteodystrophy, and later Raman Gokal on anaemia, and Gwynne Thomas and Barry McGrath on hypertension. He was by his own admission not cut out to run a research programme but enabled others to do so after suggesting problems for investigation. He drew Gwyn Williams, Peter Ratcliffe, Anthony Raine, Christopher Pugh and John Firth, into nephrology and all five went on to successful academic careers. He was known as an ideal mentor. He inspired confidence, was kind, exercised appropriately his power and influence, and gave advice, not commands. His own longstanding interest in the renin-angiotensin system was rewarded with the opportunity to investigate the use of captopril in resistant hypertension, neatly described by his then registrar, Nicholas White, in the Lancet in 1980. His broad interests made him an excellent Chairman of the Medical Research Society, Secretary of The Association of Physicians of Great Britain and Ireland, and President of the British Hypertension Society. He served on the Executive of the National Kidney Research Fund (now Kidney Research UK). He much enjoyed being a Trustee of the Beit Trust advising on scholarships and infrastructure awards to Zambia, Malawi and Zimbabwe. He was a founding Editor of the Oxford Textbook of Medicine – probably the best clinical textbook of medicine in the English language. It is now in its 5th Edition and edited by two of his protégées – Dr John Firth and Prof Tim Cox. He served the Royal College of Physicians as Censor from 1984-5 and as an MRCP Part II examiner for eighteen years. His reputation for common sense ensured invitations to serve on various bodies dealing with animal experimentation, the bioethics of xenotransplantation and coronary disease prevention.
In 1961 he met Elaine Maliphant, “a Cardiff girl”, also from a medical family (her father was an obstetrician). She was herself a doctor working at the Middlesex, specialising in Obstetrics and Gynaecology when they met. They became engaged within 6 weeks and married six months later on March 3rd 1962. Her relaxed warmth, natural intelligence and informal nature was a perfect fit for him. Their mutual love of music, particularly opera, enriched their marriage greatly. Together they did much for Oxford’s links with the Welsh National Opera. He described her as the person who so enabled his professional and family life that he could not bear to be without her. He felt guilty in later life, that she put her career second to his, but every indication suggests that she relished her role. Sadly, she predeceased him, dying in 2019. He cared for her and bore the loss of her person and her life bravely, supported hugely by old colleagues and friends. They had four daughters who helped shape his attitude toward women. He championed women at work and at home, nurturing any interest they had and supporting them both practically and with words of humanity and wisdom through their various trials. Joanna Ledingham became a consultant rheumatologist (and later President of the British Society for Rheumatology), Catherine (Marsh) a teacher and farmer’s wife, Clare (Bowron), a fiction editor at Penguin, and Sarah (Coupe), a physiotherapist.
Retirement in 1995 allowed him to pursue his passion for music, history, golf and fly-fishing. To his annoyance, a succession of afflictions robbed him of his mobility and independence but thankfully not his mind, still pretty sharp until the end which came from another bout of aspiration pneumonia which he declined to oppose.
[1] Unity and Diversity The short life of the United Oxford Hospital. by EJR Burrough
[2] The Scarlet Pimpernel
