Prof. Harold Fox 1931–2012

haroldfox-233x300One of the foremost diagnostic histopathologists of his generation, Harold Fox spent his entire professional life in Manchester. Renowned worldwide for his incisive lectures spiced with his characteristic acerbic wit, he was well rehearsed, with the ability to dissect the issues and develop an argument, often in a quite iconoclastic, but always amusing manner. In an era before the research assessment exercise, annual consultant appraisal, continuing professional development and external quality assurance schemes, he enjoyed considerable academic freedom. He spent, for example, four months in 1974 working as visiting professor at Trivandrum Medical College in the Indian state of Kerala, where he lived in a beach house at Kovalam. He published ten textbooks, contributed more than 125 chapters to textbooks and published over 230 original papers and review articles in scientific journals. In a 30 year period from 1974 to 2003, he delivered five hundred invited lectures in centres throughout the world and held visiting professorships in Melbourne, Johannesburg, Hong Kong, Perth and Ghana.

Harold Fox demonstrated that diagnostic histopathology in general, and gynaecological pathology in particular, could attract the most intellectually gifted medical graduates as a first career choice and that the specialised histopathologist with a full knowledge of the literature has a crucial role to play in conveying the nature and prognosis of often rare conditions to clinical colleagues. The tissues of hundreds of difficult cases were sent to Manchester from all over the world for his diagnostic opinion, largely unbeknown to the women from whom they originated.

His classic and award winning 1978 monograph Pathology of the Placenta, went through three editions (3rd edition with Neil Sebire, 2007) and heavily influenced current understanding of the role of the placenta in many conditions. He regarded weighing the placenta in the delivery room as “genuflections towards the altar of scientific measurement”, though the work of Professor David Barker of Southampton University has subsequently shown in epidemiological studies, that placental weight can be predictive of disease in adult life. With Page Faulk, he was a Founding Editor of Placenta from 1980 until 1989. The existence and role of the journal paralleled and to a considerable extent contributed to the flowering of placental studies over the last three decades. He made other major original contributions to the understanding of ovarian and uterine tumours and edited the major two volume British textbook, Obstetrical and Gynaecological Pathology. Like Leonard Bernstein, Simon Gray and Beryl Bainbridge, his cigarette smoking seemed to be linked inextricably to his creativity.

Harold Fox was born in Manchester in 1931. Both of his parents were born in England but three of his grandparents were born in Eastern Europe, leaving because of the anti-Jewish pogroms toward the end of the nineteenth century. His maternal grandfather built up a highly successful business as a cattle importer and meat wholesaler, which his father joined in Manchester. He was educated at Arnold School, Blackpool and at Manchester University where he graduated MB ChB (with Honours) in 1955, having been awarded the Turner Prize for Clinical Medicine. During 1955? 1958 he was successively House Physician to the Medical Professorial Unit under Robert Platt (subsequently Lord Platt), House Surgeon to the Neurosurgical Unit, Resident Clinical Pathologist and Senior House Officer in Clinical Haematology at the Manchester Royal Infirmary. During 1958?1960 he served in the Royal Army Medical Corps as a Junior Medical Specialist in Malaya and Singapore, attaining the rank of acting Colonel.

After completing National Service in November 1960, he joined the Department of Pathology at Manchester University as an Assistant Lecturer in Gynaecological Pathology under the tutelage of Professor Fred Langley. In 1964, he was promoted to Lecturer in the Department of Pathology and passed the Final Examination for Membership of the Royal College of Pathologists in 1965, becoming a Fellow in 1977. He obtained his Doctorate of Medicine in 1966; his doctoral thesis, “The Pathology of the Placenta” was awarded a Gold Medal. In 1967-68, he spent twelve months at the University of California Medical Center in San Francisco as a postdoctoral research fellow. He became Senior Lecturer in Pathology in 1967 and was appointed Honorary Consultant Pathologist to the United Manchester Hospitals in 1968. He was promoted to Reader in Pathology in 1974, and was appointed as Professor of Reproductive Pathology in 1978 and, for many years, collaborated with Dr Hilary Buckley. He was admitted as a Fellow, ad eundem, of the Royal College of Obstetricians and Gynaecologists in 1984. He became Emeritus Professor of Reproductive Pathology in 1992 but remained a Fellow of the Department of Pathology. He continued to work as a Locum Consultant Histopathologist at St Mary’s Hospital, Manchester from 1994 to 2001.

Postgraduate Obstetrical and Gynaecological Pathology, co-edited with Fred Langley, was published in 1974; Tumours of the Ovary, co-authored with Fred Langley, was published in 1976; Pathology for Gynaecologists was co-authored with Hilary Buckley (2nd edition 1991), as was Atlas of Gynaecological Pathology, both published in 1982. He edited Gynaecological Pathology: Advances, Perspectives and Problems, published in 1984, Haines and Taylor, Obstetrical and Gynaecological Pathology in 1987 (4th edition 1995 and 5th edition with Michael Wells, 2003), Biopsy Pathology of the Endometrium, with Hilary Buckley, in 1989 (2nd edition 2002) , Advances in Gynaecological Pathology (co-edited with David Lowe) in 1992 and Gynaecological and Obstetric Pathology for the MRCOG, co-authored with Hilary Buckley in 1998 (2nd edition with Hilary Buckley and Michael Wells, 2009).

He was also foundation Editor in Chief of the International Journal of Gynecological Cancer from 1991 to 2001. He was President of the British Division of the International Academy of Pathology 1984-1986, President of the International Society of Gynecological Pathologists, 1988-1989, President of Manchester Medical Society 1991-1992 and served on the Council of the Royal College of Pathologists, 1980-1983, 1986-1989 and 1990-1993.

Interviewed for the International Journal of Gynecological Pathology in 2004, he provided a lengthy and highly entertaining account of his life (International Journal of Gynecological Pathology 2004; 23: 308-315). He was asked whether he had any outstanding ambitions and replied:

“…my ambitions are largely negative: I don’t want to feel guilty about not learning a foreign language, I do not want to take classes in art or art appreciation, I do not want to drink less wine, I do not want to eat more fruit and vegetables, I do not want to take more exercise and I do not want to fly Economy Class”.

Harold Fox met his lifelong companion, Augusta Conry in 1958; they were married in 1986; they travelled widely together to many exotic destinations. He was an avid reader of detective fiction and a fan of Manchester United Football Club and “Coronation Street”. He was treated successfully for lung cancer in November 2007 but, in recent years, was increasingly disabled by osteoporosis. Nevertheless, he retained his intellectual rigour and sense of humour to the end when, after some quip, his face would become suffused with his characteristic smile.

Professor Harold Fox MD (Gold Medal), FRCPath, FRCOG (ad eundem), reproductive pathologist, born 18th September 1931, Manchester, died suddenly of cardiac failure, 21st March 2012, Manchester.

Michael Wells