The death of Sir Cyril Clarke, on November 21st at the age of 93, marks the end of the era of great medical all-rounders. His career as a clinician ranged through life insurance practice, medical specialist in the navy, consultant physician, professor of medicine at Liverpool University, and, finally, president of the Royal College of Physicians.
He was one of the first British doctors to appreciate that medical genetics, far from being a discipline which focuses on rare and esoteric diseases, has a major role to play across every aspect of day-to-day clinical practice. This led him to establish the Nuffield unit for medical genetics in Liverpool.
However, Cyril Clarke's most important contribution to medicine, and one that reflects his flair and willingness to chance his arm in problems which were often outside his field of expertise, was his inspiring leadership of the Liverpool team that discovered how to prevent rhesus haemolytic disease of the new-born, one of the major advances in preventative medicine of the last half-century. This work typified his unwillingness to be deterred by the gloomy prognostications of experts, who often said his thinking was way off the mark, and his instinctive gift for what Sir Peter Medawar called "the art of the possible".
The son of Astley Vavasour Clarke, a physician at Leicester Royal Infirmary (and one of the first to use X-rays in Britain), Cyril Clarke was educated at Oundle School, Gonville and Caius College, Cambridge, and Guy's Hospital medical school. After three years in life insurance practice, which allowed him time to indulge his passion for sailing, he served throughout the second World War as a medical officer in the navy, ending his service by writing one of his first papers, on the neurological complications of malnutrition that he observed in British prisoners-of-war in Hong Kong.
He then moved to Liverpool, where he became consultant physician at the David Lewis Northern Hospital. Despite busy hospital and private practices he, together with his longtime friend and collaborator P. M. Sheppard, began a series of classical experiments on the genetics of swallow-tailed butterflies, work which later stimulated his interest in medical genetics.
The success of his team of young, clinical research workers left less time for his clinical practice. He was appointed reader in medicine at the University of Liverpool, and, in 1963, became professor of medicine, a post he held until 1972. He founded the Nuffield unit of medical genetics, which he directed from 1963 to 1972. That year, he was elected president of the Royal College of Physicians, a post he held with great distinction and flair until 1977.
From 1977 to 1983, he was director of the college's medical services study group, and, from 1983 to 1988, director of its research unit. Among many other activities, he served as president of the Royal Entomological Society and, much to his delight, president of the British Mule Society. He spent his later retirement in Liverpool, continuing his work on the genetics of butterflies, and in a characteristically broad range of medical research.
Cyril Clarke was a caring, if slightly eccentric, clinician, very much of the old school, who believed in minimal intervention. His advice to new staff on the use of drugs came, he claimed, straight from one of his teachers at Guy's, who, as he got older, had restricted his personal pharmacopoeia to morphia and sodium bicarbonate, and was not too liberal with the bicarbonate.
As professor of medicine, Cyril Clarke led his department with a light touch, preferring to let bright youngsters go their own way, but always around if they needed support. His remarkable flair and enthusiasm, and his ability to sniff out talent and to pick research areas of importance, was undoubtedly the major factor which led to the wonderful achievement of the rhesus team, and to the success of the Liverpool department as a major influence on the development of medical genetics.
As a person, Cyril Clarke was a complex mixture; alongside the lifelong schoolboy, constantly bubbling with enthusiasm and new ideas, he could also appear distant and sometimes difficult to approach, a reflection of his innate shyness. But he was warm and extremely loyal to his staff, and supported them throughout their careers, usually behind the scenes.
In 1935, Cyril Clarke married Frieda, or Feo, as she was always known, who became an integral part of his work and other activities, ranging from crewing for him on his boat - not a relaxing pastime as he had been an Olympic trialist and hated losing - to breeding swallow-tailed butterflies in captivity. It was a remarkable partnership and he never fully recovered from her death in 1998. They are survived by three sons.
Cyril Clarke's work was widely recognised. He was elected a fellow of the Royal Society, and received many national and international awards. At the age of 88 years, still busy at his research, he wrote that he would very much like to know why butterflies have an XX chromosome complement in males and XY in females, yet the latter live much longer than the tempestuous XX males. "God moves in a mysterious way," he concluded.
Sir Cyril Astley Clarke: born 1907; died, November 2000