by Linda de Vries and Frances Cowan
Professor Andrew Whitelaw, who has died aged 79, was an active member of the Newborn Brain Society and a leading figure in the field of Neonatal Neurology. It is with great sadness that we share the news of the passing of our dear friend and colleague.
Andrew, known to all of us as Andy, grew up in Dunfermline in the county of Fife in Scotland. His father was one of two obstetricians for a population of about 100.000. At school he started to play the guitar as well as the bagpipes in the school pipes and drums. He was twice admitted to hospital at a young age. Aged six years, he was seriously ill with rheumatic fever and hospitalised for three months and when eight he suffered traumatic head injury. These experiences may have played a role in becoming a doctor himself.
In an autobiography he recently published, which we very much enjoyed reading, he tells the story of how his life and career were shaped. He says that his book is a story of scientific investigation, of clinical experience, and of individual people. He starts with telling how he met a girl who could not walk or talk because of cerebral palsy, when they were both seven years old. He was told that this was due to damage to her brain as a newborn. This made a huge impact on him and maybe set the scene for his later choices in medicine.
In 1964 he started medical school in Cambridge University, UK and as Cambridge did not have a clinical school, he went to St Mary’s in London for his clinical teaching and rotations. In 1970 he obtained a scholarship to the Montefiore Hospital in New York City, and spent time in the Neurology department, where he sat in clinics with Oliver Sacks. On his return to the UK, he started pediatrics at Northwick Park Hospital in London, spent time at Great Ormond Street Hospital for Children (GOSH) and had his first exposure to neonatology doing a six month rotation in 1974 at Queen Charlotte’s Maternity Hospital. He then was offered a research position with Professor June Lloyd in metabolic medicine at GOSH, that led to his MD thesis in 1977 entitled “The development of adipose tissue in the first year of life”. In 1978 he moved to Toronto to work with Paul Swyer as a clinical fellow in Neonatology at the Hospital for Sick Children, better known as Sick Kids.
In 1981 he became a consultant at the Hammersmith Hospital in London. He was a very good clinician and adept at clinical procedures despite only having useful vision in the right eye following a car crash in 1969 with a penetrating injury to his left eye. Here he was able to start his impressive research concerning neonatal brain injury. In 1989, having met Dr Marianne Thoresen, he moved to Oslo, he learnt Norwegian and worked there as a neonatologist. Then, with Marianne he moved, as professor, to Bristol in 1998, where he could work with the neurosurgeon Ian Pople, who had experience with coagulation of the choroid plexus in spina bifida patients and who suggested injecting TPA into the enlarged ventricles in babies with post-hemorrhagic ventricular dilatation (PHVD) so as to wash out the old blood. This work led to the DRIFT trial. At the same time, he was able to work with Marianne, who had established a laboratory in the Bristol Veterinary School, where she could study pigs and rat pups. Together with Shobha Cherian and Kristian Aquilina, a trainee paediatric neurosurgeon, they set up an animal model of IVH, and tested drugs to inhibit the formation and release of TGF beta.
We both had the privilege of working closely together with Andy at the Hammersmith Hospital in London during the 1980s. With Lilly and Victor Dubowitz there too, Neonatal Neurology started to be recognized as an important part of the field of Neonatology and Andy led the first randomized controlled trial of treatment for PHVD, the Ventriculomegaly trial. PHVD became his research focus over the years to come, not only clinical management but also studying biomarkers in the CSF, alongside animal experiments together with Marianne. Following his move to Bristol, he led the well-known DRIFT trial, and also, recognizing the importance of long-term follow-up, was able to show a reduction in severe cognitive disability at school age attributable to washing away the harmful debris of an intraventricular hemorrhage. Later, he was able to participate in the ELVIS trial, not only helping us to achieve the number of patients needed for the trial, but also giving us very valuable advice. Until the very end, he was involved in PHVD research, playing a role in the present neuro-endoscopic lavage trial (ENLIVEN), that is now enrolling babies in the UK.
Andy was a true pioneer in the field of PHVD, but together with Marianne he also played a crucial role in TOBY trial. His work on neonatal brain injury and neuroprotection changed how we understand and care for our most vulnerable patients. His knowledge covered the entire field of Neonatal Neurology. At any meeting, he would be the person to ask a very relevant question after any presentation, but always in a positive way and making use of his sense of humor. Indeed he had knowledge and well thought-through opinions about many aspects of life.
After his retirement, Andy revigorated his old passion – playing the bagpipes. He joined a group both in Bristol and later in Oslo. He also had many other interests and enjoyed sailing with Marianne in the summer, as well as cross country skiing in the winter, and looking after their many grandchildren, both in Norway as well as in the UK.
Andy’s influence lives on – in his many trainees and collaborators across the world, in the research he inspired, and in the countless newborns whose lives have been touched by his work. Those of us who knew him will remember not just his scientific brilliance, but the kindness, humour, and integrity that defined him.
He will be deeply missed, but his spirit remains with us – in every act of care, in every question asked in the pursuit of understanding the newborn brain, and perhaps, in the distant sound of a piper’s tune carried on the wind.
With gratitude and affection,
Linda S. de Vries
Frances M. Cowan