John Stewart Cameron, MD, CBE
July 5, 1934 - July 30, 2023
Stewart Cameron was the complete professor of nephrology, founding and leading an internationally famous department at Guy's Hospital. He had an encyclopaedic knowledge of the whole subject, drove the research agenda, shared in the clinical load, lectured brilliantly at home and abroad, edited and wrote scholarly books. His insightful mind and capacity for teamwork made him a natural leader of international nephrology societies. He was an effective and popular President of the Renal Association.
John Stewart Cameron was born in Aberdeen, where his father was a master mariner in the merchant navy and his mother a secretary. The family moved to London in 1946 where his father worked in film production at Ealing Studios. Cameron went to Ealing Grammar School. He was a gifted draughtsman (as had been his father) and considered art school but decided to pursue a career in medicine. He had originally intended to return to Scotland to study at Aberdeen University, however differences in school qualifications between England and Scotland meant this was not straightforward so instead he gained a place at Guy's Hospital Medical School in 1953.
He undertook an intercalated BSc in physiology, awarded with 1st Class Honours, and from then on was determined to be a clinician scientist. He graduated MB BS with Distinction in 1959. Unsure at first the branch of medicine he would pursue, Professor John Butterfield at Guy's became his mentor and after a period studying diabetes, Butterfield arranged for him to go to Cornell University, New York, supported by a Fulbright Scholarship to work in nephrology with E Lovell 'Stretch' Becker and Robert F Pitts. As well as research training, he was also exposed to the emerging techniques for treating irreversible renal failure using chronic dialysis and transplantation. At Guy's he and John Trounce had already begun the core of a renal unit, including dialysis for acute renal failure.
He returned to London in 1963 as Lecturer in the Department of Medicine at Guy's, and wrote his MD thesis on glomerular permeability to proteins in the nephrotic syndrome, based on his work at Cornell. From 1967 he was Senior Lecturer in Medicine at Guy's, then Professor of Renal Medicine in 1974, and from 1975 Director of the Clinical Sciences Laboratories at Guy's. He held both these positions until his retirement.
In 1966 he and Trounce accepted Department of Health funding to start at Guy's one of several pilot dialysis units being trialled in the UK. Recognising from the beginning that a chronic dialysis programme on its own carried the risk of unsustainable growth as more and more patients began treatment, he realised that the ideal strategy was to develop in parallel a kidney transplantation programme. With his registrar, who soon became his consultant colleague, Chisholm Ogg, he established at Guy's a large and busy unit providing all aspects of renal care including chronic dialysis and transplant. The unit grew through vicissitudes which included a major hepatitis B outbreak in 1969, although fortunately without any deaths as there had been in Edinburgh the previous year. Cameron himself was severely ill with viral hepatitis followed by prolonged post-viral fatigue.
The Guy's unit flourished and soon had an international reputation for excellence in clinical care, research and teaching, receiving visitors from all over the world, and training young physicians from many countries. Cameron and Ogg were also instrumental in developing paediatric nephrology at Guy's from the mid-1960s after Richard White moved to Birmingham, providing care for children, including dialysis and transplantation, until Cyril Chantler, a trained paediatric nephrologist, was appointed in the early 1970s.
Cameron's instinct was to foster collaboration. A hallmark of the Guy's unit was the emphasis on teamwork with nurses, dietitians, technicians and many others who contributed to kidney care. The multi-professional team he built was based on mutual respect and support; this has become the norm in renal care but at the time was highly innovative. His contributions to weekly multidisciplinary meetings with colleagues working in urology, radiology, histopathology and paediatric nephrology inspired many to commit to careers in nephrology.
From the beginning, Cameron ensured that the Guy's unit was fully committed to research alongside its clinical work. Following in the tradition of Richard Bright at Guy's he re-established the importance of longitudinal study of personally observed patients which made him a leader in the study of the natural history of glomerular disease. He made outstanding contributions in glomerulonephritis, nephrotic syndrome, and lupus nephritis, as well as renal transplantation in adults and children. He was also an authority on altered urate and purine metabolism and their impact on the kidney, working with Anne Simmonds. At the RCP he was Goulstonian lecturer (1972), Lumleian lecturer (1987) and Fitzpatrick lecturer (1998). He was fascinated by the history of medicine and was a world authority on the history of nephrology. His published output was formidable: twelve books, over a hundred chapters in books, and more than 450 papers. He was a founding editor of the Oxford Textbook of Clinical Nephrology now in its 4th Edition.
Even early in his consultant career he was prominent, both clinically and academically, in the emerging specialties of nephrology, dialysis and renal transplantation, and assumed many local and national leadership roles, including President of the Renal Association (1995-98). Inevitably his skills and attributes soon involved him in international specialty leadership. He was President of the European Society of Paediatric Nephrology (1975), the European Dialysis & Transplant Association (1984-87), and the International Society of Nephrology (1993-95). Under his leadership, the 1987 International Congress of Nephrology in London came through many challenges to great success. He was instantly spottable by his attire – polo necks and flared trousers and his Beatle haircut. At the opening ceremony he wore his Cameron kilt and sgian dubh.
Cameron's clinical and academic reputation meant he travelled all over the world teaching in many different settings, and especially encouraging the emergence of nascent nephrology in low-income countries. With his gift for friendship and his unrelenting energy, he was a much-loved mentor to hundreds of nephrologists, many of whom had come from abroad to Guy's and then returned to their own countries taking senior positions in nephrology and medicine.
His formidable intellectual energy not only underpinned his encyclopaedic knowledge of nephrology and its history. He was a multilingual polymath equally at home discussing for example Gaelic poetry, the history of Mull (where he had a second home for many years), and John Keats (who had been a Guy's medical student). Cyril Chantler recalls him as ' ….the most curiously intelligent doctor I have ever known. We used to say at Guy's if you wanted to know something about anything you either had to go the library or better still ask Stewart.'
But it is for the easy way he bore all his gifts that he is remembered with affection. His complete lack of self-importance, his enthusiasm for the work of others, his encouragement of those many he mentored whose names and personal circumstance he never forgot – it was these for which he is most loved and will not be forgotten.
Unusually for those days he had married and had two children while still a medical student, a choice somewhat frowned upon at the time by the Guy's establishment, some of whom wrongly suggested to him it might hamper his career development. Margot was a perfect foil and partner for him, and she joined him regularly on his nephrology travels.
When still at the height of his powers, he was forced to retire early from clinical and academic work following complications after urgent cardiac surgery. He retired to Cumbria, and though dogged subsequently by ill health he continued to write energetically across the range of his interests (including for example an extensive history of the Ross of Mull) and immersing himself in village life. When Margot developed dementia, he cared for her devotedly at home until her death. Emerging from his bereavement, he in due course found great happiness with Alison (née Russell) whom he met again 43 years after she had been a ward sister at Guy's. Together they had written in 1968 the first book on nursing aspects of renal disease, dialysis and transplantation which ran to two editions; they married in 2018.
He was made CBE in 1998 for services to nephrology.
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