Consultant Physician and Cardiologist ;
Born: November 23, 1922; Died: September 25, 2013.
Robert Fife, who has died at the age of 90, was widely regarded as one of the outstanding physicians and cardiologists of his generation. His early life was spent in Ayrshire. where he was educated at Kilmarnock Academy before entering the Faculty of Medicine at the University of Glasgow in 1940.
After a distinguished undergraduate career and a period of military service in North Africa, his early postgraduate training was at the Glasgow Royal Infirmary, and it was there that he became interested in cardiology, under the supervision of Dr J H Wright, a most influential figure in Glasgow medicine and in the development of cardiology. Dr Fife became one of his protégés and this period laid the foundation for his future as a well rounded physician and cardiologist.
All of Dr Fife's training was at the Glasgow Royal Infirmary, with the exception of a year spent at Law Hospital, Lanarkshire, as a senior registrar. He was thereafter appointed consultant physician at the Royal and was consultant in administrative charge from 1973 until his retirement in 1985.
At that time, very few of the current investigations were available and the assessment of the patient relied on clinical skills. Dr Fife was highly skilled and gifted in all aspects of this. Rheumatic heart disease was particularly common in those days and required expert use of the stethoscope. Dr Fife was particularly adept and passed these skills on to generations of students, although his skills extended well beyond cardiology to all aspects of medicine. This laid the basis for his gifted diagnostic talent.
Cardiology investigations in Scotland in the 1950s were more or less restricted to the electrocardiogram (ECG), which became pivotal to the diagnosis of heart attacks. Dr Fife developed a deep understanding of all aspects of it. In the early 1960s, coronary care units began to develop and he and his colleagues ran such a unit at the front end of one of the Nightingale wards in the Royal Infirmary. As the epidemic of coronary artery disease took hold and rheumatic heart disease decreased, Dr Fife adapted to this new challenge. He was expert in evaluating the benefits and risks of both cardiac and other forms of surgery and was constantly in demand for the pre-operative assessment of patients throughout the hospital. He was aware of fully assessing cardiovascular risk factors, including obesity, and his favourite question in this regard was "what weight were you when you were 21?"
The tendency for specialisation in recent years has resulted in a decrease in the development and popularity of the generalist as a career. It is of interest that in our current ageing population, the generalist is much needed and this is now being recognised and promoted.
Dr Fife exemplified this with his ability to look at all aspects of the patient and such an approach optimised their management. He promoted what he termed the working diagnoses and would document these in the notes with his famous red pen. When his trainees documented their list and he concurred, he would simply write "agreed". This, for the trainee, was the ultimate accolade.
Dr Fife contributed significantly in other areas. He was an honorary senior lecturer at the University of Glasgow and Fellow of the Royal College of Physicians and Surgeons of Glasgow, and the Royal College of Physicians of London. He was an examiner, including a host and senior examiner in the MRCP examinations for many years. He led in the development, and then served for many years as chair of the Glasgow Blood Pressure Clinic Executive which developed innovative computerised records for patients in Glasgow with high blood pressure. This resulted in a number of key research projects, with publication of a considerable number of articles in this area.
He was also chairman of the influential Area Medical Committee in Glasgow which advised the health board on key issues. In this role, his preference was always for collaboration rather than confrontation.
He retired in 1985 and his wife Isabel died in 1992. Thereafter, he met an old school friend, Barbara Johnston, and they became close companions. They enjoyed the company of their respective families, travelling, music and art.
He was the most likely choice when colleagues themselves were unwell. He appreciated the need for communicating with the patient and providing them with a clear explanation of their condition. Dr Fife exemplified all the characteristics of a complete physician. His colleagues, students and most importantly, patients, were all beneficiaries of this remarkably talented doctor.
He is survived by his daughter Anne, son, Dr R John Fife, two grandchildren and his companion, Barbara Johnston.
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