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Significant Scots
John Crofton

John Crofton, 1912-2009

Crofters: the good man who halted an epidemic
By Chris Holme

It's what every aspiring doctor dreams of – find a 100% cure for the world's most dreaded disease and then get on with more important things in life.

This was what the Edinburgh tuberculosis group led by John Crofton achieved almost 60 years ago. His memoirs, newly-published by his daughter Alison and son-in-law Dave, shed new light on how they did it.

I first met Crofton at a conference in Aberdeen on Scotland's alcohol problems. He came up and cheerfully supplied me with a ready splash for the first edition which ran throughout the day.

Later, with a reporter's cynical eye for a future obituary, I interviewed him in Edinburgh on his tuberculosis work. He lived for another 20 years during which we got to know each other well.

He was a wonderful man, who inspired prominent clinicians including Tom Frieden, current director of the Centers for Disease Control and Prevention, and many journalists. We affectionately dubbed him 'Crofters'.

Winding back to 1952 when he took up the chair of tuberculosis at Edinburgh University, Scotland was in the middle of a rising and fearsome epidemic of TB. This disease has been with mankind for millennia, capable of gnawing away at the spine, bones and other organs or, more commonly, the lungs. It was a death sentence for half of those diagnosed.

The NHS service in Edinburgh was a shambles. Crofton changed all that, bringing in his own team of consultants, including Jimmy Williamson who had previously treated George Orwell. Their approach was revolutionary using all three available drugs from the outset rather than consecutively.

Rising TB notifications in Edinburgh were halved between 1954 and 1957, a feat not achieved anywhere before or since. Waiting lists disappeared and the epidemic was halted in its tracks. Newspaper editors and broadcasters gave active support to a mass x-ray campaign in 1958 which rooted out residual TB in the city.

Many did not believe their results. When Williamson presented a paper at a conference in Istanbul, all the American delegates walked out. An international trial was arranged, which used the Edinburgh model as a protocol. It became the international gold standard for TB treatment. By then, the Edinburgh group had effectively done themselves out of a job and they moved into other areas of medicine. Williamson became one of the leaders in the new speciality of geriatrics.

Sir John's memoirs chronicle his later career, including his own two-year battle with clinical depression. They also hark back to his early years in Dublin where he played with WB Yeats's children and the Easter Rising when his nursery was peppered with bullets. He continued tirelessly campaigning on TB, alcohol and tobacco, co-founding Scottish ASH with his wife Eileen. They were delighted when Scotland introduced the smoking ban in 2006. I was later told that Crofters called me his 'spy' in the government which I took as a compliment.

Crofton died in 2009. Williamson, another wonderful man and great raconteur, was the last survivor of the Edinburgh group. He died in June this year. Novelist and geriatrician Colin Currie wrote a fitting obituary in the Scotsman.

As Tom Frieden has pointed out, the Edinburgh group's combination chemotherapy for TB later became a cornerstone for cancer and HIV treatments. Their legacy lives on.

Saving Lives and Preventing Misery, by Sir John Crofton (Fast Print Publishing)

Chris Holme is the founder of the History Company

This article was taken from The Scottish Review

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