Dr Basil C Morson

CBE, VRD, DM, FRCPath, FRCSE, FRCP, FRACS

13 November 1921 - 13 October 2016

Dr Basil Morson, one of the most eminent (if not the most eminent) gastrointestinal pathologists world-wide, died peacefully at home, in West Sussex, on 13 October 2016. He was exactly one month shy of his 95th birthday. He was a former President of the British Division of the International Academy of Pathology (BDIAP) and his contributions to the Division, and to the IAP internationally, were enormous. To recognise those achievements BDIAP Council awarded him the inaugural President’s Medal of the British Division of the IAP, for services to education in Pathology, in 2005. 

His achievements in gastrointestinal pathology and surgery are almost legendary. This is extraordinary, given that he was the only Consultant Pathologist in a small specialist hospital, St Mark’s Hospital, in London. He achieved this fame by dynamism and commitment to clinical research in gastro-intestinal pathology. Indeed, it is difficult to find any disease of the gastro-intestinal tract that Basil had either not described or had not been a major influence in the understanding of its pathology. This particularly opines to colorectal cancer, inflammatory bowel disease, intestinal polyps and diverticular disease but his earlier work was also very influential in our understanding of the development of cancer in Barrett’s oesophagus and in the stomach.

Born in London in 1921, he was the son of an eminent London-based Consultant Surgeon. He served in the Second World War as an ordinary seaman but, in 1944, he transferred to the Special Executive Branch of the Royal Navy. He trained in midget submarines and later worked as a physiologist studying the problems of deep water diving. After the war, he joined the Royal Naval Reserve and rose to the rank of Surgeon Commander, serving until 1971. His Volunteer Reserve Decoration (VRD), bestowed in 1964 for services in the Royal Naval Reserve, was an award, amongst so many, that he was most proud of.

He graduated in Medicine from the Middlesex Hospital Medical School, London, in 1949. At that hospital, in 1950, he initiated his career in Pathology. He also gained further academic qualifications at Oxford University, with an MA in 1953 and a DM in 1955. His initial pathological research at the Middlesex Hospital was in the study of gastric and oesophageal pathology. Indeed, in 1953, he was the first to describe gastric-type metaplasia in the disease that subsequently became known as Barrett’s oesophagus and he also undertook innovative work on intestinal metaplasia in the stomach as a precursor of gastric cancer. Having initiated his research in the upper gut, he rapidly progressed down the GI tract when, in the early 1950s, he started working closely with the eminent pathologist Dr Cuthbert Dukes at St Mark’s Hospital, London. It was no surprise, therefore, that he was appointed as his successor when Cuthbert Dukes retired in 1956. Basil was particularly attracted to Dr Dukes’ work on pathological specimens of colorectal cancer. Prior to that time, most studies of gastro-intestinal disease had been on autopsy specimens and Dr Dukes and Dr Morson were really the first to concentrate studies on surgical specimens. Much later, he was also a very important player in the development of endoscopic biopsy and wrote seminal articles on the pathology of such biopsies. 

During a career of almost 30 years at St Mark’s Hospital, it is extraordinary how much innovative research Basil produced. He wrote influential papers, with Sir Hugh Lockhart-Mummery, on the clinical and pathological distinction of Crohn’s disease from ulcerative colitis in the 1960s and also authored the initial description of the biopsy appearances of dysplasia complicating ulcerative colitis in 1967. In the 1970s, he produced ground-breaking work on the concept of the adenoma-carcinoma sequence in the large intestine. Particularly working with his great friend and colleague, Dr H J R “Dick” Bussey, his research remains critical to our understanding of the development of colorectal cancer. He also worked extensively on various other tumours of the gut, intestinal polyps, polyposis syndromes, inflammatory bowel disease and diverticular disease. In the 1980s, he worked closely with the late Professor Jeremy Jass and together they produced many important papers, especially on intestinal polyps and colorectal cancer.

Basil’s life was not just about clinical and academic gastro-intestinal pathology. He was also a consummate administrator and was President of the Section of Proctology of the RSM, President of the Section of United Services of the RSM, Vice-President and Treasurer of the Royal College of Pathologists and, as already indicated, President of the British Division of the International Academy of Pathology (IAP). He was the first pathologist to be President of the British Society of Gastroenterology. His esteem was such that, on his retirement in 1985, the Society created the Basil Morson Lecture, now regarded as the most prestigious named GI pathology lecture in the UK, in Europe and likely in the world. Basil himself gave the inaugural lecture in 1987. He also gave numerous prestigious named lectures around the world and his work in gastrointestinal pathology has been recognised by numerous Colleges and Societies worldwide. 

His contributions to the literature are enormous. Perhaps above all else, he conceived and wrote the first textbook of gastrointestinal pathology, forever known as ‘Morson & Dawson’, with Professor Ian Dawson. The first edition was published in 1972. That text is still the UK flagship textbook of gastrointestinal pathology with the fifth edition having been published in 2013 and a sixth edition in its early stages of production. He was the author of 11 other books, 20 book chapters and more than 200 original publications. 

Basil was proud to be a clinical pathologist. As the only Consultant in Pathology at St Mark’s Hospital, he worked very closely with physicians, surgeons, radiologists and endoscopists, all of whom appreciated his acumen in clinical medicine. Indeed, his trainees in pathology were encouraged to practice clinical medicine and not practice what he called ‘postal pathology’. This trainee, looking back more than 30 years, was often told to ‘get himself on the wards and talk to and examine patients’ as he was a “clinical pathologist”. Further, Basil was not afraid to ensure the appropriate clinical management of patients by disciplining his clinical colleagues. Many a lecture to pathology trainees would start with the words “It is your job to control surgeons”. His rationale for this was that a single inappropriate word on a pathology report could provoke unnecessary major surgery.

Basil was a man of compassion and dignity and yet had a wicked sense of humour. He was also a man of humility. He steadfastly refused the offer of Professorships, preferring instead to regard himself as a clinical pathologist and he was proud of his title of ‘Dr Morson’. When he retired in 1985, he indicated that he was going to fully retire and did not want to be ‘an old man shuffling on to the stage and embarrassing both his listeners and himself with outmoded science’. However, with his knowledge, experience and clinical guile, he was not allowed to fully retire. Indeed the research on colorectal polyps he undertook in the 1990s, with Professors Wendy Atkin and Jack Cuzick, paved the way for the establishment of a major part of colorectal cancer screening in England, instituted just two years ago.

Outside work, like so many histopathologists in the UK and elsewhere, he was a keen ornithologist and also took pride in his gardens. He married twice and had three children, Christopher, Caroline and Clare. His second wife, Sylvia, was his soulmate and they spent many happy years together. She had been the Senior Matron at the London Clinic, where Basil also worked, and she was awarded the MBE for services to Nursing. She predeceased him in 2014. In 1987, he himself had been awarded the prestigious honour of Commander of the Order of the British Empire (CBE) for services to Medicine. 

At St Mark’s Hospital, he had many visiting Fellows in Pathology from all round the world, especially the USA and Japan. Many of those Fellows have gone on to become world leaders in gastrointestinal pathology themselves, such as Professor Tetsu Muto, from Japan, and Professors Stan Hamilton and Joel Greenson from the USA. It is testament to his reputation and teaching skills that so many of these Fellows, and indeed many gastrointestinal pathologists who never worked with him, have acknowledged his huge contribution to their professional lives. There is no doubt that Basil’s legacy to pathology, and gastroenterology, is immense. Whilst his textbook, Morson and Dawson, remains his greatest legacy, his prodigious scientific output is still, thirty years after his retirement, of major influence in our understanding of gastrointestinal diseases.

Professor Neil A Shepherd, DM FRCPath 
Professor of Gastrointestinal Pathology & Consultant Histopathologist 
Gloucestershire Cellular Pathology Laboratory 
Cheltenham General Hospital