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years at The Lancet The editors The founder of The Lancet, Thomas Wakley, is well known as a powerful figure whose outspoken and radical views dominated the journal over many decades. His influence went beyond his own term as editor, as the journal was handed first to one son, then the other, and finally to his grandson. The Wakley dynasty ran the journal for 85 years but the 20th century demanded new approaches, and a series of remarkable men took charge of the journal and steered it through the fast-changing world of medicine and journalism. Continuity was maintained by the practice of appointing, in most cases, from within the existing staff of the journal. The story of the editors is the story of the journal itself. These were men of their time-no women so far-who stamped their own ideas on the journal, but who did so within the framework of reliable and radical reporting which the Wakleys established. There have been only 12 editors during the journal's 175-year existence, and their biographies provide a rare insight into the interface between personal qualities and professional achievements during this period.
Thomas
Wakley (1795-1862)
He founded The Lancet to expose and combat the corruption and nepotism that he found in the medical profession, and it was his inspiration and indefatigable work that led to the journal's success. Wakley was a great social reformer who also relished confrontation, and his life was littered with court cases. He was coroner for West Middlesex, and, as Member of Parliament for the Finsbury constituency, he took up many causes including that of the Tolpuddle Martyrs. His capacity for work was immense, and he had his carriage modified to serve as an office as well as a dining room. In 1851, he collapsed from exhaustion and later developed phthisis. He eventually retired to Madeira but he could not resist meddling in local affairs.
James
Goodchild Wakley (1825-86)
As editor, he made no pretension to a thorough knowledge of medicine or science, preferring to leave this side of the journal's work to his staff. Instead he devoted himself to extending the public function of the journal, and he invited many influential writers of the day to contribute articles on public-health issues, particularly the unsanitary conditions in factories and workplaces. He was greatly assisted in his task by his sub-editor Ernest Hart, and when Hart was offered the editorship of the British Medical Journal, his resignation sparked the "30 years' war" between the two journals. There were threats of libel and even physical violence. James Wakley was a notable boxer with a fierce temper. It is said that the editorial room was often the scene of personal fracas, always bitterly regretted afterwards.
Thomas
Henry Wakley (1821-1907)
On his return, he was appointed to a surgical post at the Royal Free Hospital, London, a move that gave ammunition to his father's critics, who thought that the appointment had been rigged. At the same time, his father made him an assistant editor, working alongside his brother but without any requirement for regular attendance at the office. He eventually became editor when his younger brother James died, but continued to work part time, leaving the day-to-day running of the journal to his staff and increasingly assisted by his son "Young Tom". He maintained his surgical career, and in 1881 became president of the Royal College of Surgeons, to which he donated a substantial £200 000. He enjoyed a more leisurely lifestyle than his father, typically spending his winters in Brighton and commuting to London by train.
Thomas
"Young Tom" Wakley (1851-1909) He learned the art of journalism from his Uncle James who died in 1886
leaving Young Tom and his father Thomas Henry as joint proprietors and
editors. It is said that they made a good combination because their
ideas of duty were alike but their methods were at variance, the elder
being "always young and impetuous" and the younger "always deliberate".
As an editor, Young Tom had an exceptionally good memory for detail
and no article passed through his hands without thorough scrutiny. He
wrote very little himself on the grounds that an editor should remain
impartial and that it was exceedingly difficult for a man who wrote
not to take sides.
His leisure time was devoted to freemasonry and his valuable coin collection.
When Young Tom died at the age of 58, the Wakley dynasty finally came
to an end.
Squire Sprigge (1860-1937) Medical practice had no appeal for him, so he spent most of his time
in literary pursuits. When he joined The Lancet in 1892, he was asked
to document the history of the journal and its founder. The result was
The Life and Times of Thomas Wakley published in 1899.
Sprigge is credited with bringing to an end the 30 years war' between
The Lancet and the British Medical Journal which had resulted from the
animosity between the Wakleys and Ernest Hart of the BMJ. He continued
to write extensively and published several books including Medicine
and the Public and Some Consideration in Medical Education. In 1921,
he published a volume of essays entitled Physic and Fiction.
Egbert Morland (1874-1955) The editor of the journal, Squire Sprigge, was impressed with his work,
so when Morland called into the office during a visit to London, Sprigge
invited him to "stay and help". This casual acquaintance began a career
with the journal that lasted over 30 years. At work, he was noted for
his vigorous pruning of unnecessary words. His correspondence was brief
and usually confined to a postcard, his conversation cryptic. It was
said that he seldom asked a direct question or answered one comprehensibly;
this contributed to his air of mystery.
Nevertheless, he steered the journal safely through the war years,
overseeing a move to Aylesbury for 4 years, and ensuring that weekly
publication was maintained. Morland was also a founder member of the
Quaker Medical Society.
Theodore "Robbie" Fox (1899-1989) Robbie Fox's work at The Lancet brought together his commitment to
health services, to medical science, and to grammar. As an editor, he
is said to have read every word before the journal went to print, and
his staff received long and arduous instruction in the art of sub-editing.
He reduced the use of referees, to speed up the assessment and publication
of papers, and rapidly established himself as an outstanding editor
whose commitment, judgment, and thoroughness were much admired.
He was strongly marked by his Quaker inheritance, with a dislike of
luxury and dedication to duty, although he once described himself as
being only a "demi semi quaker". His wit and word play were legendary,
as was his capacity for hard work. He wrote extensively, and his ideas
on medical journals were summarised in Crisis in Communication. Even
in retirement, he spent the winter months making his own Christmas cards.
Ian Douglas Wilson (1912- ) In 1944, he submitted a clinical paper to the BMJ, which led to the
offer of a job from the editor, Hugh Clegg. As a radical, Douglas Wilson
refused to join what he described as a reactionary and conservative
publication. Clegg advised him to try The Lancet, which he did; he remained
there for 30 years.
He was an outspoken opponent of routine peer review, believing that
it resulted in an overcautious approach. His own preference was for
a swift response to events, and he was responsible for reducing the
long delays between acceptance and publication of papers.
His radical instincts were most strongly tested during the 1959 UK
printers' strike when, in the absence of the editor he was forced to
print the journal in Bremen, Germany, to ensure continuity of production.
As editor he enjoyed an occasional snipe at authority. When Lord Moran,
President of the Royal College of Physicians and physician to Winston
Churchill, published personal details about Churchill after his death,
he felt the cold draught of Douglas Wilson's disapproval.
Ian Munro (1923-97) A private man, he wrote extensively for the journal on a wide range
of subjects during his 37-year career. The characteristic clarity and
elegance of his writing reflected both his strong views and his passion
for Shakespeare.
He was committed to the UK National Health Service and, although he
offended a number of Secretaries of State with his views, he quite enjoyed
their disapproval. During his editorship, the journal explored links
between health and human rights and exposed a wide range of injustices
despite considerable pressure to remain silent. He became involved in
issues such as the prevention of nuclear war and was the first President
of Physicians for Human Rights (UK). As a Yorkshireman he always found
time to indulge his lifelong love of cricket.
Gordon Reeves (1938- ) He was an eminent academic, whose experience included posts at the
Royal Postgraduate Medical School, London, and membership of advisory
committees of both the Royal College of Physicians and the Royal College
of Pathologists. His experience of publishing had been gained as a student
when he edited the Guy's Hospital Gazette. His arrival coincided with
the journal's move to Bedford Square, London, after 60 years in Adam
Street. His tenure as editor lasted less than 2 years.
These editorial experiences did not quell his enthusiasm for research
and he continued to contribute extensively to various journals. He published
several books including Immunology in Medicine: a Comprehensive Guide
to Clinical Immunology, and Lecture Notes on Immunology.
Like his predecessor, he was a keen cricketer and a member of Nottinghamshire
County Cricket Club.
Robin Fox (1939- ) After qualifying in Edinburgh, he joined The Lancet in 1968 and, as
joint deputy editor under Ian Munro, built an editorial team of talented
young clinical and scientific writers who helped in the journal's quest
for key papers. He also reintroduced, with the current deputy editor
David Sharp, the practice of systematic peer review.
Fox's Quaker genes and education made their mark and ensured continued
prominence for coverage of medical social issues, but he loathed the
managerial duties required of an editor. Nevertheless, he was highly
successful in negotiating the difficult switch of the journal's ownership
in 1992 to Elsevier-Science.
He once advocated that editors should not be in post for more than
5 years so as to encourage innovation. After 5 years he moved on.
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Wakley's
extraordinary life started in a quiet Dorset village in England, where
he was the 11th child of a local landowner. His admiration for Sir Astley
Cooper led him to study medicine at the United Hospital in London, but
it was the influence of his friend William Cobbett that persuaded him
into publishing.
The
younger son of Thomas Wakley, James joined The Lancet in 1852 to assist
his father, who by then was overworked and exhausted. Although he qualified
in medicine, he never practised, and his work on the journal was more
suited to his reforming interests.
As
the eldest son of Thomas Wakley, Thomas' life was dominated by his overbearing
father. He studied medicine, first at Oxford and then at the newly established
University College London, but he was not allowed to specialise in dermatology.
Instead, he was sent to Paris to pursue his medical education.
Under
family pressure, Young Tom studied medicine at Cambridge but abandoned
the course after completing his first MB. Then at the age of 30, the
expectation of work at The Lancet "forced" him to take up medicine again.
He completed his studies at St Thomas's but never practised.
After
86 years of control by the Wakley family, Samuel Squire Sprigge was
the first non-Wakley to become editor, and he worked for The Lancet
for 45 years. Born in Norfolk, he had a natural gift of clear expression
and a taste for the company of writers. After 3 years at Cambridge,
he went to St George's Hospital, London, where he qualified in 1887.
Morland
grew up in South London, and his considerable aptitude for science earned
him a scholarship to study medicine at St Bartholomew's Hospital. His
early ambition was to become an ophthalmologist, but he contracted tuberculosis
and was sent to Switzerland for treatment. The experience persuaded
him to specialise in tuberculosis and remain in Switzerland, where he
also started to write for The Lancet.
Coming
from a long line of Quaker doctors, Robbie Fox's decision to study medicine
was inevitable. He trained at Pembroke College, Cambridge, and then
at the London Hospital where he worked for some years before joining
The Lancet in 1925. His commitment to free health care for all made
him a strong advocate of the concept of a national health service.
After
qualifying from Edinburgh, Ian Douglas Wilson practised in Wales and,
during the war, served with the Royal Army Medical Corps.
After
training at Guy's Hospital, London, Ian Munro served in the Royal Army
Medical Corps and was contemplating a career in radiology when a vacancy
at The Lancet was advertised. He maintained that Robbie Fox, who appointed
him in 1951, said that anyone who could write a really good letter must
be able to recognise a bad one and therefore had the makings of an editor.
Gordon
Reeves was The Lancet's shortest ever serving editor and the only one
who did not rise through the ranks. When Ian Munro retired, the owners
of the journal, Hodder and Stoughton, decided that a high-profile candidate
was needed.
With
the appointment of Robin Fox to the editorship, The Lancet was reverting
to tradition and selecting from within existing staff. When he joined
the staff, it was probably hoped that he would resemble his father-the
former editor Robbie Fox-who was happiest when delivering wise words
wittily to an audience. This was not to be. Fox junior was a man of
silences, which seemed to last forever as he sought the perfectly grammatical
sentence.