Robert Donald Cohen

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Clinical scientist and authority on acid–base regulation. Born in Plymouth, UK, on Oct 11, 1933, he died in London, UK, on Oct 17, 2014. The essential and, in due course, successful mergers of various London medical schools that took place in the mid-1990s proved to be a stressful experience for the academics involved. One such was Bob Cohen. As Professor of Medicine and Director of the Academic Unit of the London Hospital Medical College (LHMC) when it merged with its counterpart at St Bartholomew's Hospital, he was in the thick of it. “It was a difficult and bruising time”, says John Monson, Emeritus Professor of Clinical Endocrinology at what is now Barts and The London School of Medicine and Dentistry. “There was an atmosphere of confrontation.” It was hardly an episode for which Cohen would have wished in what were his last few years before retirement. But the merger went through: a process in which Cohen's personality played a valuable role, according to Graham Hitman, Professor of Molecular Medicine and Diabetes in the combined schools. “He was fantastically calming, able to see the big picture, to see how Barts and the London could be together.” The experience no doubt served Cohen well when he played a central part in a second merger, this one in 2002 between the Imperial Cancer Research Fund (ICRF) and the Cancer Research Campaign. Absurdly, these two organisations, which shared the same goal, had for decades been rivals in fund-raising. Although Chairman of the Council of the ICRF, Cohen managed to avoid partisan disputes. “He brought dispassionate reasoning to the merger”, says Monson. That Cohen managed these things was no surprise to Professor Peter Kopelman, Principal of St George's, University of London. “Bob was very good natured. I cannot recall him ever losing his temper or his cool. A natural leader, but very collegiate in the way he worked. He attracted loyalty and support.” These personal and organisational skills were most evident in the latter part of Cohen's career, long after he'd established his reputation as a clinical scientist. The son of a general practitioner, Cohen trained at Cambridge and LHMC and, aside from a couple of brief stints at the Royal Postgraduate Medical School, spent most of his working life at the London Hospital, becoming Professor of Metabolic Medicine in 1974, and Director of the Academic Medical Unit 8 years later. His principal research interest throughout much of that time was in acid–base disorders, often working with clinical pharmacologist Professor Frank Woods. “Together they produced a classification of lactic acidosis which still stands to this day, and they coauthored a book on the topic”, says Monson. “What they did was differentiate between those forms of lactic acidosis which occur because of low blood pressure and reduced perfusion of peripheral tissues, and another situation in which the liver is failing to remove and metabolise lactate.” Kopelman thinks that Cohen's attraction to the topic was partly stimulated by his interest in the biguanide anti-diabetic drug phenformin that was found to cause lactic acidosis in patients with impaired renal function. “Another interest he had was with renal tubular acidosis type four which gives you hyperkalaemia as well as metabolic acidosis”, Kopelman adds. Hitman remembers one more of Cohen's later research interests, a study prompted by the work of the Southampton epidemiologist Professor David Barker. “Bob picked up on Barker's ideas about fetal programming, and wondered how they might effect the biochemical functioning of the liver.” He used one of Barker's low protein animal models of fetal programming and showed that fetal malnutrition could affect a change in the expression of certain liver enzymes. “It was an example of how Bob was always prepared to think through problems in different ways”, says Hitman. Kopelman says Cohen was “extremely warm, kind to his juniors and patients, and intellectually inspirational. His grasp of mathematics was exceptionally good, especially for a physician, or even for your average scientist.” Cohen was married to a fellow physician, Barbara Boucher, whom he met while a student. She was also a consultant in the Medical Unit at the London Hospital. Temperamentally the two complemented each other perfectly, says Hitman. “Ring up at night to get advice from Bob Cohen and you'd hear Barbara booming out in the background. They were a partnership.” In addition to his wife, Cohen also leaves a son and a daughter.