Richard Asher

Richard Asher
Born	Richard Alan John Asher 3 April 1912(1912-04-03) Brighton, Sussex [1]
Died	25 April 1969(1969-04-25) (aged 57) Marylebone, London [2]
Cause of death	Suicide[3]
Occupation	Physician
Spouse	Margaret Augusta Eliot
Children	Peter Asher Jane Asher Clare Asher
Parents	Felix and Louise Asher née Stern

Richard Alan John Asher, FRCP (3 April 1912, Brighton – 25 April 1969, Marylebone) was an eminent British Endocrinologist and Haematologist.^[3] As the senior physician responsible for the mental observation ward at the Central Middlesex Hospital^[4] he described and named Munchausen syndrome in a 1951 article in The Lancet.^[5]

Personal life

Richard Asher was born to the Rev Felix Asher and his wife Louise (née Stern). He married Margaret Augusta Eliot at Pancras, London on 27 July 1943,^[6] whereupon his father-in-law gave him a complete set of the Oxford English Dictionary, which physician and medical ethicist Maurice Pappworth alleged was the source of Asher's 'accidental' reputation as a medical etymologist.^[7] They had three children: Peter Asher (born 1944) - member of the pop duo Peter & Gordon and later record producer, Jane Asher (born 1946) - film and TV actress and novelist, and Clare Asher (born 1948) - radio actress.

The Asher family home above his private consulting rooms at 57 Wimpole Street was briefly notable when Paul McCartney lived there in 1964-1966 during his relationship with Jane Asher.^[8]

In 1964 Dr Asher suddenly gave up his hospital post and perhaps all medical activities.^[4] He suffered from depression in later life and reportedly died by his own hand at the age of 57.^[3]

Ideas and reputation

Asher was regarded as "one of the foremost medical thinkers of our times",^[9] who emphasised the need "to be increasingly critical of our own and other people's thinking".^[10] Dr Asher was particularly concerned that "many clinical notions are accepted because they are comforting rather than because there is any evidence to support them".^[11]

Richard Asher was hailed as a pioneer^[12] in challenging the value of excessive bed rest following treatment,^[13] and argued that the Pel-Ebstein fever (a fever characteristic for Hodgkin's disease) was an example of a condition that exists only because it has a name.^[14] Asher's 1949 paper "Myxoedematous Madness"^[15] alerted a generation of physicians to the interaction between the brain and the thyroid gland. As a result, young and elderly psychiatric patients are now screened for thyroid malfunction.^[16] Some of the 'madness' cases are now thought^[17] to be the early descriptions of Hashimoto's encephalopathy, a rare neuroendocrine syndrome sometimes presenting with psychosis.

Notable articles

Richard Asher is remembered today chiefly for his "refreshingly provoking"^[3] articles that "sparkle with sequins--his own aphorisms, imaginary dialogue, fantasies, quotations."^[18] He thought that medical writing should provide "useful, understandable, and practical knowledge instead of allotov-words-2-obscure-4-any-1,2-succidin-understanding-them."^[19] Anthologies of his articles were well-received,^[9][20] with the Talking Sense collection being described as "still the best advice on medical writing."^[21] Notable articles include:

• The Dangers of Going to Bed (1947) - "one of the most influential medical papers ever written"^[22]
• The Seven Sins of Medicine (1949, in Lancet 1949 Aug 27;2(6574):358-60)
• Myxoedematous Madness (1949)
• Munchausen’s syndrome (1951, in Lancet 1951 Feb 10;1(6650):339-41)
• Respectable Hypnosis (1956)
• Why Are Medical Journals So Dull? (1958)
• The Talking Sense trilogy:
  • Clinical Sense (1959) with a rueful correction in The Dog in the Night-time (1960)
  • Making Sense (1959, in Lancet, 1959, 2, 359)
  • Talking Sense (1959, in Lancet, 1959, 2, 417)

The Seven Sins of Medicine

Main article: Seven Sins of Medicine

The "Seven Sins of Medicine"^[3] is a lecture delivered by Asher and later published in The Lancet, describing medical professional behaviour that is considered inappropriate. These sins are often quoted to students:

1. Obscurity
2. Cruelty
3. Bad Manners
4. Over-specialisation
5. Love of the Rare
6. Common Stupidity
7. Sloth

The Richard Asher prize

Since 1995 an annual prize (2010 value £1,200) in memory of Richard Asher has been awarded by the Royal Society of Medicine and the Society of Authors for the best first edition textbook aimed at undergraduate students.^[23] The most recent prize was awarded to Hugo Farne, Edward Norris-Cervetto and James Warbrick-Smith for their book "Oxford Cases in Medicine and Surgery". The prize was presented by at a ceremony at the Royal Society of Medicine in London on Wednesday 27 October 2010.

References

1. ^ GRO Register of Births: JUN 1912 2b 394 BRIGHTON - Richard Asher, mmn = Stern
2. ^ GRO Register of Deaths: JUN 1969 5d 1959 ST MARYLEBONE - Richard Asher, DoB = 3 Apr 1912
3. ^ ^{a b c d e} Rowat, Bruce M.T. (1985). "Richard Asher and the Seven Sins of Medicine". Humane Health Care (Volume 1, Number 2). http://www.humanehealthcare.com/Article.asp?art_id=126. Retrieved 2008-03-20. 
4. ^ ^{a b} Anonymous (1969-05-10). "R. A. J. Asher (Obituary notice)". British Medical Journal 2 (5653): 388–388. doi:10.1136/bmj.2.665.388.  Full text at PMC: 1983233
5. ^ Asher R (1951). "Munchausen's syndrome". Lancet 1 (6650): 339–41. PMID 14805062. 
6. ^ GRO Register of Marriages: SEP 1943 1b 4 PANCRAS - Asher = Eliot
7. ^ Lock, Stephen (2003). "The words of medicine, R. Fortuine (book review)". Med Hist 47 (1): 139.  Full text at PMC: 1044791
8. ^ Vickers, Graham (2001). Rock Music Landmarks of London. Omnibus Press. ISBN 0711986754. http://books.google.com/?id=ZYU3euLYMAgC. 
9. ^ ^{a b} Drew, Robert (1973). "Richard Asher Talking Sense by Francis Avery Jones (review)". Proc R Soc Med 66 (5): 488.  Full text at PMC: 1644921
10. ^ Asher, Richard (1954). "Straight and Crooked Thinking". Br Med J 2 (4885): 460–462. doi:10.1136/bmj.2.4885.460. PMC 2078909. PMID 13182247. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2078909.  Full text at PMC: 2078909
11. ^ Talking Sense quoted in "Endpiece". Br Medical J 2 (4885): 1532. 1999.  Full text at PMC: 1115904
12. ^ Sharpe M, Wessely S (1998). "Putting the rest cure to rest--again". BMJ 316 (7134): 796–800. PMC 1112768. PMID 9549447. http://www.bmj.com/cgi/content/full/316/7134/796.  Full text at PMC: 1112768
13. ^ Asher, Richard (1947). "Dangers of Going to Bed". Br Med J 2 (4536): 967–968. doi:10.1136/bmj.2.4536.967.  Full text at PMC: 2056244
14. ^ Hilson AJW, DiNubile MJ (1995). "Pel-Ebstein fever". N Engl J Med 333 (1): 66–67. doi:10.1056/NEJM199507063330118. PMID 7777006.  They cite Asher's lecture Making Sense (Lancet 1959;2:359)
15. ^ Asher R (1949). "Myxoedematous madness". Br Med J 2 (4627): 555–562. doi:10.1136/bmj.2.4627.555. PMC 2051123. PMID 18148089. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2051123.  Full text at PMC: 2051123
16. ^ Kiraly, Stephen; Ancill, Raymond; Dimitrova, Gergana (May 1997). "The Relationship of Endogenous Cortisol to Psychiatric Disorder: A Review" (PDF). Canadian Journal of Psychiatry 42 (4): 415–20. PMID 9161767. http://ww1.cpa-apc.org:8080/Publications/Archives/PDF/1997/May/Kiraly.pdf. Retrieved 2008-03-20 
17. ^ Garrard P, Hodges JR, De Vries PJ, Hunt N, Crawford A, Hodges JR, Balan K (January 2000). "Hashimoto's encephalopathy presenting as "myxodematous madness"". J. Neurol. Neurosurg. Psychiatr. 68 (1): 102–103. doi:10.1136/jnnp.68.1.102. PMC 1760600. PMID 10671115. http://jnnp.bmj.com/cgi/pmidlookup?view=long&pmid=10671115. 
18. ^ Ruth Holland's introduction to A Sense of Asher, quoted in "From a flea's teeshirt". British Medical Journal 313 (7072): 1654–1656. 1999-12-21. http://www.bmj.com/cgi/content/full/313/7072/1654. Retrieved 2008-03-20 
19. ^ Asher, Richard; Wright, MD (1947-11-15). "All the Vitamins". British Medical Journal 2 (4532): 788–788. doi:10.1136/bmj.2.3278.788. PMC 2056092. PMID 20340806. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2056092 
20. ^ Greene, Raymond (1972-11-04). "Wit and Wisdom". British Medical Journal 4 (5835): 306–306. doi:10.1136/bmj.4.5835.306-a. http://www.pubmedcentral.nih.gov/pagerender.fcgi?&artid=1788854. Retrieved 2008-03-20 
21. ^ Kay, H.E.M. (May 1, 1983). "How to Write and Publish Papers in the Medical Sciences (review)". Journal of Clinical Pathology 56 (5): 607. PMC 498301. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=498301 
22. ^ Dr James Le Fanu (2004). "In sickness and in health". Daily Telegraph. http://www.telegraph.co.uk/health/main.jhtml?xml=/health/2004/10/11/hdoc10.xml. Retrieved 2008-03-20. 
23. ^ "Medical Books Awards". The Society of Authors. 2008. http://www.societyofauthors.org/prizes-grants-and-awards/prizes_for_medical_books/prizes.html. Retrieved 2008-12-10. ^{[dead link]}

Persondata
Name	Asher, Richard Alan John
Alternative names	Sir Richard Asher
Short description	Doctor
Date of birth	1912-04-03
Place of birth	Brighton, Sussex
Date of death	1969-04-25
Place of death	Marylebone, London