Bryan Jennett

Bryan Jennett (1926– 2008) was a pioneering Professor of Neurosurgery who established Glasgow as a world centre in the speciality and made major advances in the care and management of patients. Under his leadership the city became a global centre for innovation in Neuroscience and attracted a generation of international collaborators and trainees to the extent that his ‘Glasgow School’ has left an extraordinarily widespread legacy. He influenced not only fundamental improvements in treatment for head-injured patients but the methodology, philosophy and ethical approach of clinicians and academics alike in the wider medical field.

Born in Twickenham to Scottish and Irish parents, Jennett flirted with agriculture before choosing medicine. Later, he was to discover that the Lanarkshire based farming dynasty from which he was descended had produced no fewer than five Doctor Loudons including one who was physician to David Livingstone the explorer. His early achievements at Liverpool Medical School included marrying his classmate Sheila Pope, finishing top of his year and becoming President of the national British Medical Students Association.

Jennett was drawn to Neurosurgery after attending the lectures of Henry Cohen, 1st Baron Cohen of Birkenhead and he went onto take posts at Oxford, Cardiff and Manchester as well as a spell in the Royal Army Medical Corps. However, his academic interests were not congruent with the times and he was turned down for promotion in Oxford, Manchester and Dundee. This was the early NHS era with a greater emphasis on patronage and where academic interests were sometimes perceived as a hindrance. Indeed, he was nearly lost to America after a year- long Rockefeller Fellowship at UCLA, but was headhunted in 1963 for a new combined NHS/University post in Glasgow. Here he joined a fledgling unit which operated from a converted wartime complex in the village of Killearn. The Glasgow gamble was based as much on the attitudes and aspirations of his new colleagues and mentors as it was on the intangibles of long term potential. Over the coming decade, with the support of figures like Sir Charles Illingworth, he rose from Consultant to Professor and the Nissen huts gave way to a purpose built unit at the Southern General Hospital. Meanwhile Jennett’s collaborative research programmes started to flourish.

Before arriving in Glasgow Jennett published a seminal work on epilepsy, and shortly afterwards his “Introduction to Neurosurgery” followed. This definitive handbook would run to five English and numerous foreign language editions over the following quarter century. In the quest to tackle enduring uncertainties, Jennett set up an unprecedented prospective computerised data bank to collect the features and outcome of injuries. Data was compiled from Glasgow, the United States, and the Netherlands over a long period and led to a series of landmark papers in the 1970s, including the near universally adopted Glasgow Coma Scale (GCS) with Teasdale, and the deceptively simple Glasgow Outcome Scale with Bond. In 1972 working with Dr Plum of America, Jennett published The Persistent Vegetative State – defining a condition and coining a phrase which remains in widespread use today. His work with the Glasgow-based Neuropathologists Adams and Graham significantly reduced mortality and disability. Many international collaborative studies followed, comparing outcomes after different severity of injury and with alternative therapeutic regimes. Throughout the period his work was distinguished by his selfless partnerships with his peers and generous encouragement of his juniors - at one time over half the Neurosurgical Chairs in the UK were occupied by his trainees. This manifested his determination that his colleagues not encounter the same career obstacles that he had.

Jennett cut a distinguished if diminutive figure; a lifelong taker of informed risks, this courage often sheltered under his confident style and calm tenor. He brought an infectious energy to his work and his inclusive, egalitarian approach brought his inspiration and support to many nurses, assistants, statisticians, administrators and others with whom he worked. For his part Jennett was always keen to promote the role of others in his team. All these qualities were underpinned by assured surgical and diagnostic skills and a frank but sympathetic approach at the bedside which lives on in the memory of hundreds of patients and their families.

The same expertise, conviction and clarity of thought and expression often placed him in the public spotlight. In 1976 there was furore over a BBC Panorama Programme which challenged the criteria used to establish ‘brain death’ in potential organ donors. Professor Jennett was in global demand as a speaker and in the UK contributed to many influential medical panels and was called to Court as an expert witness, most notably for the Tony Bland case. However, his interest was not confined to the medical establishment; he was President of Headway – a national patients group - for seven years.

Whilst Dean of Medicine at Glasgow in the 1980s Jennett tackled issues which overarched medicine and society. Very much ahead of his time, he tackled the appropriate use of high cost technology in medicine - working with Barbara Stocking and Chris Ham of the King's Fund to establish a series of Consensus Conferences. This form of technology assessment is now central to several health department initiatives. A Presidency of the International Society for Technology Assessment followed and in 1984 his paperback “High Technology Medicine: Benefits and Burdens” followed a series of BBC talks Doctors, Patients & Responsibilities which were widely praised. His approach is well illustrated by his response to a personal experience of deep-vein thrombosis (DVT) which he attributed to cramped aircraft seating. Within a year he had located colleagues who had similar experiences and together they published a short paper in The Lancet and first used the term “Economy-Class Syndrome” which stirred up opinion amongst the public and the airlines. The subsequent research and our current stance to the condition owe much to this original paper.

Following his retirement in 1991 he received the CBE and an honorary DSc from St Andrews University. His continuing work included a 2002 monograph ‘The Vegetative State’ and his final publication appeared in the British Journal of Neurosurgery in the month before his death.

References

• John Pickard (16 February 2008). "Professor Bryan Jennett, Neurosurgen". The Independent (London). Retrieved 2008-05-03. 
• "Professor Bryan Jennett". Times Online (London). 19 February 2008. Retrieved 2008-05-03. 
• Sir Graham Teasdale and Sam Galbraith. "Bryan Jennett". The Herald. Retrieved 2008-05-03. 
• Ken Lindsay (19 March 2008). "Bryan Jennett". The Guardian (London). Retrieved 2008-05-03. 
• Caroline Richmond and Graham Teasdale (1 March 2008). "William Bryan Jennett". British Medical Journal. Retrieved 2008-05-03.