It is 50 years since one of Scotland’s unsung medical heroes died.
Aberdonian, RD Lawrence may not be a household name but people with diabetes owe him a debt of gratitude for transforming diabetes care and for co-founding one of Britain’s biggest patient voice charities, Diabetes UK.
Dr Robert Daniel Lawrence, ‘Robin’ to family and friends, was an aspiring surgeon at King’s College Hospital in London when he was diagnosed with Type 1 diabetes at the age of 28. He tried to control his diabetes with a strict diet but his health deteriorated over the next three years and he was not expected to survive.
However, his life was saved by a momentous medical breakthrough: the discovery of insulin. Lucky to be alive, RD Lawrence devoted the rest of his long, productive professional career to the improvement of care and treatment of other people with diabetes with whom he shared a hard-won empathy and understanding.
Angela Mitchell, Director of Diabetes Scotland said: “RD Lawrence is recognised as one of the most influential figures in the history of diabetes care in this country. He was a charismatic figure who faced the challenges of a lifetime with Type 1 diabetes with scientific and clinical curiosity.
“It was Lawrence who promoted the idea, which we now take for granted, that improving the treatment of people with diabetes depends upon a close, ongoing partnership between clinicians and patients.
“And his book, The Diabetic Life – which ran to 14 editions and several translations – gave practical and accessible advice on the control of diabetes using diet and insulin. Lawrence’s authoritative but naturally cheerful and positive disposition greatly encouraged his patients and his life’s work remains an inspiration to people living with diabetes.”
Born in Aberdeen on 18 November 1892, RD Lawrence attended Aberdeen Grammar School – coincidentally the same school that the co-discoverer of insulin, JJR MacLeod attended - before studying medicine at Aberdeen University where he enjoyed a glittering undergraduate career winning gold medals in Anatomy, Clinical Medicine and Surgery and excelling in sport. Lawrence’s seemingly charmed life, however, was blighted by the First World War which claimed the lives of many close friends and fellow students.
After graduation, he served in India with the Royal Army Medical Corps before taking up the post of House Surgeon in the Casualty Department at King's College Hospital in London. Unfortunately, while practising his skills on a cadaver, a bone chip flew into his right eye and the resulting infection left him with permanently impaired vision which ended his career as a surgeon.
Shortly after, Lawrence was diagnosed with Type 1 diabetes which, at the time, was regarded as a death sentence. He initially controlled his diabetes with a rigid diet but his health continued to deteriorate and, believing he only had a short time to live, Lawrence moved to the warmer climes of Florence, Italy and set up in practice there. His diabetes took a turn for the worse after an attack of bronchitis and an early death seemed inevitable.
However, with great fortuitous timing, Lawrence’s illness coincided with the discovery and isolation of insulin by Banting, Best, Collip and Macleod in Toronto, Canada in 1922. Supplies began to reach the UK and in May 1923, a colleague at King's College Hospital cabled Lawrence with the urgent message: I've got insulin – it works – come back quick. Lawrence returned to London - weak and disabled with complications related to his diabetes – more in hope than expectation.
He then spent two months in hospital receiving regular insulin injections which restored him to robust health and vigour. It must have seemed like a miracle and gave Lawrence a second chance at life which he grasped with characteristic energy and enthusiasm. He became physician-in-charge and the driving force behind the setting up and subsequent success of one of the earliest and largest diabetic clinics in the UK at King's College Hospital and devoted the rest of his life to improving the care and welfare of people with diabetes.
Lawrence wrote The Diabetic Life and The Diabetic ABC which helped to demystify treatment for diabetes for both doctors and patients. He published widely on all aspects of diabetes and its management, producing some 106 papers including important publications on the management of diabetic coma, on the treatment of diabetes and tuberculosis and on the care of pregnancy in diabetics.
Ahead of his time, Lawrence recognised the importance of patient engagement in furthering research as well as education and welfare. With his Type 2 diabetes patient, the celebrated author and scientist H.G. Wells, Lawrence co-founded the Diabetic Association in 1934, the first patient-oriented association to be established in the United Kingdom and now known as Diabetes UK. Lawrence died, aged 76, on 27 August 1968.
Angela Mitchell, Director of Diabetes Scotland said: “It's 25 years since Diabetes UK opened an office in Glasgow but the Scottish influence on the charity goes right back to its establishment in 1934.
“Diabetes UK is RD Lawrence’s lasting legacy and I’m sure he would approve of our continuing work to support people living with the condition, campaign for improved care and fund vital research towards a world where diabetes can do no harm.”