First Thomas Pickering memorial lecture*: ambulatory blood pressure measurement is essential for the management of hypertension.

Abstract

THOMAS G. PICKERING Dr Thomas George Pickering, physician, clinical scientist, professor and mentor, editor, husband, father, and grandfather, died on May 14, 2009, at the age of 69 from complications of brain cancer, an illness that he had fought with dignity and courage for more than a year (Figure 1). Tom was educated at Bryanston School in Blandford, England, where he won state and entrance scholarships. He went on to study medicine at Trinity College, Cambridge, and the Middlesex Hospital Medical School, London, where he graduated in 1966, being awarded the first Broderip Scholarship. His early postgraduate years were spent at Middlesex Hospital and the Radcliffe Infirmary. He sat for the membership of the Royal College of Physicians of London in 1968 (becoming a fellow in 1980) and went on to earn a PhD degree at Oxford University in 1970. In 1972, he went to New York to take up appointments as Associate Physician at the Rockefeller University Hospital and Assistant Professor at Cornell University, and he spent 2 years as Assistant Professor at the Rockefeller University working with Neal Miller on biofeedback mechanisms. He was appointed Assistant Physician to the New York Hospital in 1974. He later returned to the Radcliffe Infirmary to work with Peter Sleight on research into baroreceptor function, the autonomic nervous system, and the emerging class of cardiovascular medications, known as the adrenoreceptor blockers. He was attracted back to New York City by the possibility of being able to work as both a practicing physician and a clinical investigator and he spent more than 20 years in a productive career in behavioral cardiovascular medicine, clinical hypertension, and blood pressure (BP) measurement research at Cornell University Medical College. In 2000, he became Director of Behavioural Cardiovascular Health and the Hypertension Program at the Cardiovascular Institute of Mount Sinai Medical Center and in 2003 he moved to Columbia University Medical College as Professor of Medicine and Director of the Behavioural Cardiovascular Health and Hypertension Program. So much for Dr Pickering, the scientist, what about Tom the man we came to love and admire? Tom was the quintessential Englishman, mannerly, gentle, and gentlemanly (the two must not be confused) whose enquiring mind was tinged with that spirit of philosophy whereby he knew nothing was new under the sun, but that what was fundamental to science was the expression of fact and the style of that expression. He was aware that each small brick added to the edifice of knowledge would enhance our understanding of hypertension and ultimately benefit those we graduated to serve as doctors—our patients. My first contact with the Pickering family was with Tom’s father, Sir George Pickering, when we were seated together on a bus taking us from the airport to a hotel in Valetta in 1975. I recall a man of small stature in an incredibly grubby raincoat who talked animatedly to me about the new drugs for the treatment of hypertension. However, my abiding memory is of his kindness to me the following morning when I was the first speaker in a session chaired by him in what was probably my first address to an international audience (Figure 2). As I prepared to begin my presentation there was the unmistakable sound of slides cascading from a carousel to the floor, whereupon Sir George looking encouragingly at me said ‘‘And now we will see how the young doctor from Dublin can convince us without slides!’’ Fortunately, during my sleepless night of rehearsing my lecture I had written prompt cards for each slide a precaution acknowledged by Sir George as ‘‘being a lesson to us all not to rely on slides.’’ Tom’s mother, Lady Carola, was a regular attendee at the British Hypertension Memorial Lectures named after her late husband. The most memorable of these was the ninth Sir George Pickering Lecture delivered in Dublin by Tom in September 1991 on ‘‘Ambulatory Monitoring and the Definition of Hypertension.’’ At dinner at the Royal College of Surgeons she remarked to me: ‘‘Eoin, I am so pleased; I never thought Tom had it in him.’’ How little mothAddress for correspondence: Eoin O’Brien, DSc, MD, FRCP, Department of Molecular Pharmacology, The Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland E-mail: eobrien@iol.ie