Henry Joseph Macaulay Barnett

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Kathleen Gourlay

 

 

Biography
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One of our most distinguished members, and a world figure in neurology, Henry Barnett (Barney). What he really wanted to be a was a naturalist. The medical schools chosen by him for the multi-center international clinical trials for which he is famous do often seem to be close to bird sanctuaries. A child of the manse, he skipped Sunday school to frequent sewage lagoons with his binoculars. To this day he is a leader in conservation, with much of the preservation of primary forest in the King Township area due to his years of persuasion. He was able to get the Prime Minister of Canada into his living room, and there wring two hundred and fifty million dollars out of him for the Nature Conservancy of areas needed by threatened plant and animal species.

Our class soon recognized the leadership qualities of this UTS product, made him our president in second year, and kept him there for life. He, Joan Borland and Bob Delaney have made this class unusually close-knit over the years, arranging so many splendid reunion dinners, and Barney now has initiated these biographies to make use of Joan’s remarkable collection of archives and correspondence.

The editor of the 1944 Torontonesis yearbook describes him as a “collector of canaries and a cooker of colossal deals.” The latter referred to his rental of a train to take those participating in the Graduation Dance booked for the famous Brant Inn in Burlington to enjoy a train ride to the dance in an era of gasoline rationing. He persuaded a colleague and from the class of 4T5 to co-sign the CNR agreement. It was not a sedate evening as we now recall.

The most important event of his abbreviated junior internship at TGH was his introduction to the beautiful and wise Miss Kathleen Gourlay, a student nurse, with whom he shared a lifetime of family joys and accomplishment.

After our infantry training at Brockville and Borden, Barney served in the RCAMC in Newmarket, then moved on to a year of pathology with the great William Boyd and neuropathologists Eric Linell and Mary Tom. His years of residency training in internal medicine and neurology in Toronto were followed by two Nuffield Fellowship years at Oxford and Queen Square Hospital in London, England where he and neurosurgeon Charlie Drake, with Kathleen and Ruth, began a happy association, both professional and family, lasting throughout their lives.

On return to Toronto, he was a fellow for a year and joined the Toronto General Hospital staff, where the neurologists Hyland, Richardson and Walters all combined psychiatry with their neurological practices. Barney was the first to practice undiluted neurology. During this time his work on paraplegics with Al Jousse at Lyndhurst resulted in the recognition of the entity of post-traumatic syringomyelia, and led to his later classification of the syringomyelias.

During these years of busy practice and teaching at TGH and then Sunnybrook Hospital, Barney came to believe in the merits of combining neurological medicine, surgery, pathology and radiology in one department, as no other universities had done; but Toronto General and the University of Toronto were not receptive to the idea. However, his friend Charles Drake who was making a name for himself in neurosurgery at the University of Western Ontario in London jumped at the idea, persuaded Angus McLachlin and Ramsay Gunton, the heads of surgery and medicine, and transplanted Barney to UWO. Thus began the team who, as they gathered clinicians and researchers around them, made London a world centre in neurologic science. Interdisciplinary work paid dividends.

As the years went by, and he saw so many stroke patients, Barney’s fertile mind recognized that assumptions about treatment were made that should be questioned, and that the answers, so important to millions of people, must be obtained in very large clinical trials of absolute integrity. Stimulated by Fraser Mustard, he first addressed the preventive use of aspirin, alone and in comparison with other platelet-inhibiting agents. As he led this huge Canada-wide study involving dozens of investigators, his diligence and intense personal scrutiny set the standard for studies of this kind. His subsequent trials regarding indications for carotid artery surgery, and cerebral artery bypass were equally effective in defining appropriate care.

It is not surprising therefore that Barney became the world’s leading consultant in stroke care. He was editor-in-chief of the journal Stroke, visiting professor at scores of universities, recipient of four honourary degrees, invited author of hundreds of papers and chapters, was the first North American to receive the Stroke Research Award of the Karolinska Institute in Sweden, is a Companion of the Order of Canada, and to this day flies off regularly to address meetings in such places as Texas and South Africa.

In his later years Barney realized the need for new and much larger research facilities in London.  He was the prime mover, drawing support from the hospital CEO Patrick Blewett and many business people who admired the work of Barnett and Drake, in the creation of the highly successful Robarts Research Institute, now associated with the University of Western Ontario.

He managed to publish over 200 peer-reviewed manuscripts in major journals, (more than a dozen in the New England Journal,) several of which have been classified as “classics” on citation indices. Not being other than a practicing doctor this gives him pride in knowing that it is possible to accomplish, and alter practice universally by work outside the laboratory. He made two singular observations of previously unrecognized disorders: post-traumatic syringomyelia, mentioned above, and stroke from emboli from a prolapsing mitral valve.

He was elected an honourary member of a number of neurological societies, including: the American Academy of Neurology, the American Neurological Society, the Hungarian Neurosurgical Society, the Mexican Neurological Society, the Australian Neurological Society, Association of British Neurologists, New Orleans Academy of Medicine, Royal Society of Medicine (UK), and an Honourary Foreign Member of the Russian Academy of Medical Science, as well as an Honourary Corresponding Member of the Indian Academy of Neurology.

Oxford honoured him with an honourary degree (D.Sc.). He also received Honourary Degrees from the University of Western Ontario, Utrecht, Dalhousie and New York Institute of Technology.

Finally, Barney may very well feel that his greatest contribution to the future is the four children he and Kathleen raised: one physician, one naturalist, one author married to a naturalist, and one author married to a neurosurgeon. And then there are the grandchildren, of whom two are in the medical pipeline, one (Brian) being the third generation of Drakes in the Toronto Neurosurgical program.

 

Awards and Honours

Canadian Medical Hall of Fame, 1995

Order of Canada

Honourary Doctor of Science, University of Western Ontario and Oxford

Karolinska Medical Research Prize

Lifetime Achievement Award, Canadian Neurological Society

Career Achievements

Founder and Scientific Director at Robarts Research Institute

Created combined CNS Department at University of Western Ontario

 

Excerpt written by: Dr. Neil Watters

Personal Story

Since the Memoirs and the Epic Journey of U of T Class 4T4 were printed, a remarkable event has engulfed me Its significance is such that I feel compelled to add some details to both publications in their internet format. This is done with the urging and consent of my associates.

I was astonished in October 2011 to receive from the Chancellor’s office of Oxford University an indication that they wished to present me with a degree of Honorary Doctor of Science. Until I heard that a body called “The Congregation” approved of the plan I was to say nothing about it. Accordingly I shared it only to my family and fellow writers.

Before the year-end, approval was sent and with a new light-weight wheel chair and my two sturdy sons we set out on June 17 to Heathrow by Air Canada (me business class and they steerage). We had rooms at the Royal College of Physicians house near Regent’s Park. (Once an honorary member always a member.) Reasonable for downtown London as prices had already risen anticipating the coming Olympics . Will & Ian snatched a half-day along the Embankment, Westminster Hall etc and in late afternoon we all went by train to Oxford. All of us were accommodated in St Edmunds Hall, tended by its friendly and gracious President, Professor Keith Gull.

All members of the Congregation and the honorees assembled by a centuries-old custom to partake of champagne, peaches asd strawberries, to meet each other and the Chancellor in the courtyard of Exeter College. I was then pushed in the new chair to the Sheldonian Theatre. The route included cobblestones sufficiently unfavorable to the footrests of my chair that they came apart Riding several blocks over cobble-stones with feet held in front was a good exercise and test of the thigh muscles.

Customarily at this rigidly handled function which is given the Greek name Encaenia (traditioally translated as “a festival of dedication”) they recognize benefactors and give honorary degrees usually to 7 academics but after Daw Suu was assured of her return to Burma by visa we became 8. By custom these are considered the choice of the Congregation and represent distinguished literary persons, physical and medical
scientists, theologians, artists, musicians ,judiciary and business persons of special note.

In front of the Congregation the most senior undergraduate prizes were read out in Latin by the Public Orator and presented from all colleges and disciplines. This year they numbered eleven including law, statistics, fine art, psychology and medicine. 

The 8 of us were lined up in the main aisle of the Theatre and when our names were called we were escorted to the front. A few steps above was the Chancellor, Lord Patten of Barnes. First to go up to be hooded was Daw San Suu Kyi from Burma, attempting to restore democracy to her country, with what can optimistically be described as early success.As a rare departure from tradition of many centuries she was invited to addess the Congregation. Next came Baroness Manningham-Buller, recently retired as head of MI5 (Britain’s Security Service); then David Cornwell (pen name Le Carre), author of famous spy stories; Madam Drew Faust, (President of Harvard University); Sir Howard Stringer (Chair,Sony Corporation); CharlesTaylor (philosopher McGill); HJMB (neurologist-to hood whom the Chancellor graciously came down to floor level), William Phillips (Physicist-Nobel Laureate from Maryland). A remarkable collection.

The citations were printed in the program in English and in Latin. In presenting each to the Chancellor the ”reader” (a classics scholar) described us to him in fluent Latin the careers of all 8 of us. At the conclusion of the conferring of the doctorate degrees (One in Civil Law, four in Letters and 2 in Science), we then proceeded to St.Hugh’s College for a sumptuous Chancellor’s lunch, and Oxford’s Lord Mayor presented Daw Suu with the Freedom of Oxford.

After lunch we went to a Garden Party at Worcester College in a park-like setting. As at the lunch, the sons and I were surrounded by old friends and former colleagues who worked with me at Queen Square in Toronto or London (all now heads of Departments or of medical schools), one now Professor and Head in Florence Italy, one Dean in Calgary, one was Head of neurology at Mayo Clinic, but now CEO of the Clinic. Sir Richard Peto and I shared a glass of wine. His biostatistical skills had helped me by making evidence-seeking trials feasible, I had too- brief visits with Joanne McCormick, Egle Inzitari and Angelika Buchan. Sir Roger Bannister an old Q.S. acquaintance and fellow-neurologist was an invitee in his capacity of President of one of the Colleges. Lord Walton and I studied together in London in our youth. He added great pleasure as always. Next day he was invited to a special combined session of both Houses of UK Parliament to hear Daw Suu speak. The following day she dined with the new President of France. I became and remain in her spell! One of the world’s bravest and determined women and confirmed believer in non-violent change. I told her that she ranked with one of my other three heroes, Ghandi. She responded that she did not rank with him nor Martin Luther King nor Mandella: ”They all accomplished, I am only trying.” What a trial
period!!

This remarkable day ended by a push in my chair to a dinner at Corpus Christi College hosted by Alastair Buchan (Oxford’s Dean of Medicine) A great host and friend of many years.

Thus ended a couple of days comparable to none others in my first 90 years!

This addendum to my now printed Memoirs was sparked by a unique happening in June 2012 that must be added as the “ Memoir of the Oxford trip.” For the 8 of us lined up for Honorary degrees, a citation was read out in Latin for each, fortunately with an English version in the proceedings of the Encaenia. By my colleagues I was persuaded to reproduce here my own citation from the Proceedings:

“Dr Henry Barnett, CC, MD, was born in England and emigrated to Canada as a child (of 3). He graduated from the University of Toronto Medical School (age 17) before undertaking postgraduate training in neurology in Toronto, London and Oxford,where he worked with Charles Symonds, Hugh Cairns and Richard Doll. He was a member of Toronto’s neurology faculty from 1952 to 1969, in 1967 he founded the Department of Neurosciences at Sunnybrook Hospital and 2 years later co- founded the world’s first multi-disciplinary department of clinical neuosciences at the University of Western Ontario. He was chaiman of the department from1974 until 1986 when he co-founded (with Charles Drake) the Robarts Research Institute which he led for 8 years.

Dr. Barnett oversaw the first randomized trial across Canada to establish the efficacy of aspirin in stroke prevention. This landmark study published in 1976,not only showed that I was possible to prevent stroke but also demonstrated the necessity pf robust methodology in
such clinical trials.

Subsequently he ran two large stroke trials: the first disproved the value of cerebral bypass surgery to prevent stroke ,at the time one of the most common surgical procedures in the United States: the second, in conjunction with a separate European study, established which patients were most likely to benefit by carotid artery surgery to prevent stroke. He is currently Professor Emeritus at the University of Western Ontario.
His hundreds of publications include the standard stroke reference work: Stroke: Pathophysiology, Diagnosis and Treatment. He is a Companion of the Order of Canada. His many other honors include the 2008 Karolinska Award fo Excellence in Stroke Research, the highest award for stroke research and honorary degrees from the University of Western Ontario, Dalhousie and Utrecht Universities and the New York Institute of Technology.

Stroke is a cause of universal anxiety for there is surely no one who does not have friends or family who have been assailed by its ravages or maybe suffered attack himself. So anyone who, like the man you now see before you, has found ways of prevention it is
rightly hailed as a friend of the human race. Once more I present one of Canada’s most distinguished citizens; this one though, was born in our country at Newcastle upon Tyne. He is amused by the thought that the building in which he was born became a home of ill repute; however, his own father was a clergyman,whose appointment as a bishop took him and his family across the Atlantic. The son came back to England after finishing his training and worked for a time here in Oxford before returning home again. There his many discoveries soon made him a legend. He demonstrated that some strokes which had been previously attributed to cardiac events were actually brought about by narrowing of the arteries. He and his colleagues were the first to prove that the humble aspirin could not only serve to soothe minor discomfort but could also provide the arterial system with a measure of protection. But useful though this pill may be it could not prevent all stoke so he sought further for a cure and found that if the carotid arteries like blocked drains could be cleared out, blood would flow more freely to the brain and combat the risk of attack. He also taught the scientific community how the use of randomized trials could show the relative risk impact of such factors as age, blood pressure or diabetes. Accordingly, he is by general consent the world’s leading stroke neurologist. A nature lover and a passionate bird watcher, a loving and beloved grandfather and great-grandfather,he now enjoys a well-earned retirement in rural Ontario, but to adapt Virgil:
In his years were seen
A youthful vigor and autumnal green

I present a most distinguished hierophant of Hippocrates,Henry Joseph Macaulay Barnett, CC, founder and former director of the Robarts Research Institute, to be admitted to the honorary degree of Doctor of Science.

Final words of Oxford’s Chancellor:

Eminent master of the medical art, to whose work. so many owe health and life itself I on my own authority I admit you to the honorary degree of Doctor of Science.

References

Barnett, Henry, Joan Borland, Jack Laidlaw, Neil Watters and Bruce Wells. The Epic Journey of University of Toronto Medical Class of 1944. Toronto: University of Toronto, Faculty of Medicine. 2012. pg. 16-18.

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