Obituary: Cecil Helman

Abstract

I first met Cecil about 20 years ago and, since I retired, we shared an office we both visited at irregular intervals. His side of the room was a reflection of his polymath personality – the surface of his desk, and the surrounding floor space were totally covered with heaps of articles, periodicals and books on many different topics. I often found myself standing by his chair reading a fascinating article on a subject perhaps vaguely related to medicine. Cecil Helman, humanist, teacher, writer, general practitioner, and medical anthropologist, died at the age of 65 on the 15 June 2009 from motor neurone disease. Cecil was brought up in South Africa. He came from a family of numerous doctors (and rabbis) and finding the gravitational pull towards medicine irresistible, qualified from the University of Cape Town in 1967. His father was a government psychiatrist and in Suburban Shaman: tales from medicine's frontline, he describes how, unlike other children who spent their summer holidays on the beach, he accompanied his father on his trips to various mental hospitals. Shortly after qualifying he left South Africa repulsed by apartheid and the prospect of serving as a conscript in the South African army at a time of increasing civil unrest. He moved to cold and damp London and after a spell as a ship's surgeon eventually became a general practitioner (GP), practising part-time in north-west London for a quarter of a century. However, for Cecil literature and art were as important as the science of medicine. He was fascinated by people, their cultural and ethnic backgrounds, the narratives of their illnesses, their interaction with practitioners, and the role of traditional healers in many different societies. As he said, to be an effective healer, a doctor needs to ‘understand the storyteller as well as the story’. He took a postgraduate degree in social anthropology at University College London (UCL) in 1972 and won a Fellowship in Social Medicine at Harvard Medical School in 1982–3. In addition to his work as a GP he also became professor in the School of Social Sciences at Brunel University and senior lecturer in the UCL Research Department of Primary Care and Population Health. Cecil was a leading exponent of the discipline of medical anthropology; he was convinced that it was only possible to make sense of patients’ problems if these were put in the context of their different cultures and social backgrounds and belief systems, even if these beliefs did appear sometimes to be somewhat weird. Culture, Health and Illness was first published in 1984 and became a standard textbook in many countries. It is now a classic, in its 5th edition, and has had a considerable influence on biomedical practitioners, encouraging them to engage with the concepts of anthropology. Other books he published include, The Body of Frankenstein's Monster, Body Myths and The Exploding Newspaper and other Fables. The importance of his work was recognised on both sides of the Atlantic and he received a number of prestigious awards. These include Career Achievement Award of the American Anthropological Association's Society for Medical Anthropology 2004, The Lucy Mair Medal for Applied Anthropology 2005 from the Royal Anthropological Institute of Great Britain and Ireland ‘to honour the application of anthropology … to the active recognition of human dignity’ and the George Abercrombie Award 2008, presented by the Royal College of General Practitioners ‘for special meritorious literary work in general practice’. Suburban Shaman: tales from medicine's frontline, was selected by the BBC as a Book of the Week and serialised on BBC Radio 4 in 2006. It also won the UK Medical Journalists’ Association 2007 Open Book Award. I am not surprised that this ‘mosaic of memories’ is so popular. When I read it I imagined myself in the room with Cecil listening to his patients’ stories, absorbing their emotions and sharing his response to this very diverse and sometime bizarre group of characters. I attended a couple of his courses. He was an inspiring charismatic teacher, able to convey his enthusiasm to students who always seemed to arrive eager and on time for each and every session. He was an individualist, whose approach was somewhat different from the more conventional academic GP. He was not an enthusiastic supporter of the medical establishment and sometimes found it difficult to accept the need for university departments to focus on teaching an overcrowded curriculum to large numbers of medical students, and obtaining grants for large multicentre number-crunching research projects. Nevertheless, he considerably enriched our department of general practice, reminding us that we are generalists, committed to the practice of holistic medicine in an increasingly diverse society. We are the poorer without him.