Andrew Lawson, who has died aged 55, was a consultant anaesthetist whose ability and curiosity led him beyond his specialism into the worlds of intensive care, medical ethics and medical history.
A transformational figure in the field of pain control who set up three pain clinics and took a sabbatical year to study medical ethics, Lawson devised and ran the first multidisciplinary conferences in order to encourage other consultants to think beyond their subject. Never a man to miss the opportunity for a good time, he held these conferences in the Alps during the skiing season.
Andrew Douglas Lawson was born in North Berwick on November 30 1958. His Irish mother had trained as a nurse and his Scottish father was a naval officer. Educated at Cranbrook School, Kent, Andrew studied arts subjects at A-level before applying to study Medicine.
After Guy’s, Lawson trained in anaesthesia at the Middlesex and at Barts before moving to Bristol. He then worked for a time in Hong Kong before joining Professor Michael Cousins to set up a new pain clinic at the Royal North Shore Hospital in Sydney, Australia. There he assembled a group of physicians to address the agonies brought on by conditions ranging from cancer to shingles. The goal was “to make pain manageable and to allow [patients] to return to a full and active life”.
He was then invited to do the same at Canberra Hospital, before returning to Britain in 1994, where he repeated the process at the Chelsea & Westminster. Funding difficulties meant he set up the pain clinic and ran it at the same time as working in the Intensive Care Unit. Lack of funds also meant that he had to run the clinic out of a cupboard-sized room in the orthopaedic outpatient department.
At the time patients were sent to such pain clinics as a last resort. In many cases their specialists had given up on them and pain had taken over their lives. Patients had to wait months, even years, for an appointment. The situation reflected the common attitude to pain in hospitals: for patients pain was the number one priority; for medical staff it barely registered as an issue.
Lawson successfully challenged that attitude, and from inauspicious beginnings went on to develop a multidisciplinary pain management department at the Chelsea & Westminster, the first of its kind in Britain. He introduced a range of innovations. These included treating pain early, bringing the acute pain team into everyday hospital practice, and better pain education for doctors and nurses. He tackled his patients’ pain from every angle. As well as nerve blocks and injections, he used techniques from psychology to acupuncture – in which he trained himself.
He was not one to give up easily. His wife recalled a grateful patient inviting them to dinner at the Special Forces Club. The man, a former spy, had suffered years of pain after undergoing torture. Lawson had transformed his life with an intravenous pump inserted into the spine.
In 2003 Lawson became a consultant in Anaesthesia and Pain Management at the Royal Berkshire Hospital, Reading, working there until ill health forced him to retire in 2007. At the age of 48 he had been diagnosed with mesothelioma, a rare cancer caused by asbestos. As he wrote in an article for The Telegraph: “It seems that, while at medical school, I was exposed to asbestos fibres in some part of the hospital (four other doctors and dentists from my era developed the disease; I am the only one surviving).” Given a year to live, he approached his own illness as he did everything else – with gusto and determination. He investigated the evidence; took advice from colleagues all over the world; and was ready to try anything. He had three operations and six different chemotherapy courses. He signed up for clinical trial gene therapy treatments in Philadelphia and dendritic cell vaccine in Holland. At his own instigation he was the first mesothelioma patient in the country to have regular treatment with intravenous bisphosphonate after promising results on mice in Western Australia. The one year stretched to seven.
Lawson was aware of the fact that he had access to potential treatments which were not an option for the average patient: “I knew where to look and who to ask. It was clear to me that most NHS patients were simply not told about such trials” – another issue in which he campaigned for change.
He continued to be as active as he could. He wrote articles for The Times, The Sunday Times and The Telegraph; lectured widely on medical ethics and studied for an MPhil in Social & Economic History at Worcester College, Oxford; raised money for charity by cycling across Thailand; and spoke as both doctor and patient to conferences on mesothelioma. In a particular mark of courage, he continued to give his talk on “End of Life Care” to medical ethics meetings, the last only months before his own death.
A prolific writer of articles on anaesthesia, ICU medicine, medical ethics and health care, his books included Ethics and Law in Intensive Care (2010, with others); and Anatomy for Anaesthetists (jointly with Prof Harold Ellis). The ninth edition of the latter, on which he completed work in the final stages of his illness, was published last December.
Lawson was always willing to help patients suffering from mesothelioma, or offer advice to friends with cancer. “Hello, Cancer Central,” he would announce cheerily when they called.
Andrew Lawson, married, in 1989, Juliet Cohen, also a doctor, who survives him with their three children.
With thanks to The Telegraph, Obituary - 4 April 2014