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RIP John L Haybittle (RGS 1932 – 1940)

JOHN L HAYBITTLE
b. 18.10.1922 – d. 19.11.2017
RGS 1932 – 1940

We are sad to hear that Dr John Haybittle passed away on 19th November 2017, aged 95.

John attended Reigate Grammar School through winning a Scholarship place in 1933. Later, the Headmaster (Mr Allison) negotiated with the Leverhulme Trust to arrange a scheme whereby if somebody won a County Scholarship to go to Oxford or Cambridge, the Leverhulme Trust would then supplement that award to make it financially viable. His life would have been very different if none of this financial assistance had been made. It was only due to this supplementary funding that John was able to take up his place at St Catharine’s College, Cambridge in 1940. After two years his studies were interrupted by the war, during which he served as a radar officer with the RAF. In 1942 he married Mary, with whom he was to share 74 happy years together.

After the war John returned to Cambridge to complete his degree, and then spent two years teaching Physics in Norwich before taking up a post as a Medical Physicist within the Radiotherapy Department at Addenbrooke’s hospital in Cambridge in 1948. John then spent the rest of his career at Addenbrooke’s, beginning as a member of staff in the Radio therapeutic Centre and ending as Head of the Physics Department. Radiotherapy treatment saw immense changes over the years and John was involved at all levels.

John became well known in his field with scientific papers and awards to his name. The Haybittle-Peto boundary is referred to when clinicians decide to stop a successful clinical trial early and the Brinkley/Haybittle research paper made a significant contribution to current clinical management of early breast cancer.

What does a Medical Physicist do? A large part of their clinical work is ensuring that radiotherapy treatment optimises the radiation dose to the cancer and minimises doses to adjacent tissues. Checks are required to ensure that the equipment is delivering the right dose to the right place. This sounds and is purely technical, but John also experienced and described the emotional cost of being alongside patients on a daily basis throughout their treatment.

He became involved in many other areas. Working with Professor J S Mitchell, he helped to develop several new types of radiation treatment. Cobalt-60 gamma radiation was introduced at an early stage. John made monthly visits to the Atomic Energy Research Establishment in Harwell, collecting and returning radioactive material, and he helped to adapt one of the first high-energy linear accelerators from Harwell for patient treatment at Addenbrooke’s. He also designed and calibrated a machine for using beta particles from strontium-90 to treat skin tumours. This pre-dated by some 30-40 years the now routine use of high energy electrons from linear accelerators to treat several types of tumour.

In the 1960’s John regularly lunched with the other physicists but it was noted that he was always in a hurry to get away because he had negotiated a small time slot on the Cambridge University computer – note the THE – the only one at that time! John had recognised how the power of data analysis provided by a computer could enhance radiotherapy treatment planning. His numerous contributions in this area are recognised in a volume entitled ‘Radiotherapy Treatment Planning’, part of a series on cancer management published in 1983 and still extensively cited.

His department responsibilities were varied. Not all of them serious. He was often called upon to be Father Christmas at the Old Addenbrooke’s site – on one memorable occasion, he stood on a decorated bath chair, cheering on six black stockinged nurses hidden under a red blanket as they pulled him along for a tour of the wards.

In the late 1960s John was closely involved in planning the transfer of the department to the new Addenbrooke’s site. This was a major logistical task, planning not only for the new Medical Physics Department but also for a greatly enlarged radiotherapy treatment area with new machines and other facilities. He took on the newly created and much needed role of Radiation Protection Officer for the area. Working with Professor Mitchell he set up a “Film Badge Service” to monitor scattered radiation levels and help protect people working with radioactive materials in a variety of settings.

John went on to teach physics and statistics for Fellowship examinations of the Royal College of Radiologists, statistics for anaesthetists, supervise Ph.D. Students, be an examiner for medical and surgical degrees as well as examining for Part I of the Fellowship of the Royal College of Radiologists. He also had a welcome ability to Chair meetings of both regional and national bodies, working parties or research groups. In 1981 he helped to choose and commission the first whole body CT scanner at Addenbrooke’s.

In the later years of his career, John became increasingly interested in the use of clinical trials to evaluate the effectiveness of diagnosis and treatment of cancer. He worked with Diana Brinkley on early breast cancer screening and his analysis of the Kings/Cambridge Trial for the treatment of early breast cancer is a model to this day. As co-author of the Haybittle-Peto boundary he helped establish a rule for deciding when to stop a randomised controlled clinical trial prematurely for ethical reasons. This is used if the treatment group clearly shows evidence of benefit. In other words, “when early results proved so promising it was no longer fair to keep patients on the older drugs for comparison, without giving them the opportunity to change”.

John was a member of and then Chairman of the British Breast Group – a multidisciplinary group of medical specialists with particular interest and expertise in breast cancer. After retiring from medical physics in 1982 he continued to work in the Medical Research Council Cancer Trials Office in Cambridge.

Throughout his career, John was a longstanding supporter of the British Institute of Radiology and their journal. He had over 25 papers published in the Journal of Radiology: more than half of these were devoted to radiotherapy physics and the majority of the rest to clinical trial design and statistical analysis.

In 1967 John was one of the first Cambridge Alumni to be awarded a Doctorate for published research. In 1972 John was awarded the Roentgen Prize for ‘outstanding contributions to the Journal’. In the 1980s he served as Honorary Scientific Editor of the Journal for five years.

In 1987 John was awarded the Barclay Medal from the British Institute of Radiology, one given to those who had ‘contributed materially to the advancement of the science and practice of radiology’. A colleague wrote in the Journal that ‘reading John’s practical approach to the design of clinical studies is still an undisputed “must” for all radiation oncologists. A generation of radiotherapists will long remember his lucid and humourous teaching of medical statistics in the FRCR Part I course. …. and that despite his exemplary service in the role of Honorary Editor of the Journal, it is as an outstanding contributor to the Journal by his wide-ranging scientific output that his achievements are recognised by the award of the Barclay Medal.’

Science and a scientific approach were important to John but other matters concerned him deeply. In 1964 he wrote a paper entitled ‘Ethics for scientists’ which was published in the bulletin of the Atomic Scientists. Here John spoke of his belief ‘in the supreme power of love at all levels of human relationships’. He wrote ‘it is, I believe, within the context of a religious outlook (using that term in its widest sense) that the scientist must form his ethical judgements. Science alone is not enough. It is wisdom without compassion.’ Throughout his life he would continue to write about ‘the ever widening gap between what science allows and what we should actually do’,

John wrote in his middle age that he would not call himself a ‘Christian’ but that he now found the teachings of Jesus more ‘vitally compelling and more revolutionary in their implications than ever before’. However, he did not believe and never came to believe in the exclusiveness of Christianity but in ‘a much more all-embracing view of the other great religions’ …’men differ spiritually as well as physically, and different forms of religious belief answer to different needs’. John found his spiritual home in the teachings of Jesus but he believed there were many spiritual homes.

All people mattered to John, were to be valued. It was John who went out of his way to make the case for all employees to be valued when pay rates were being reviewed, or to urge his physicist colleagues not to show ‘Intellectual arrogance or denigrate those with less scientific skills’.

Community mattered. He was not afraid to speak out. He supported CND and joined the Aldermaston marches. He supported the anti-apartheid movement. A letter to the Listener in 1958 provided the BBC quotation of the week, as he protested at the value placed on the acquisition of material goods and services. He would continue to challenge materialism for the rest of his life.

He held the view strongly, that ‘the values of society as a whole are compounded from the values held by its individual members, and we should not underestimate the influence of our own example either for good or bad …. The great thing is not to despair or give in.’

John is survived by his wife Mary and only surviving daughter Rebecca and family. They have written that while he was fortunate to have work of great interest to him throughout his career, he also placed great value on his rich home and community life outside work. John’s interests ranged from walking, folk dancing, poetry reading and writing and involvement in amateur dramatics as both an actor and producer. In the village of Great Shelford where they lived for over fifty years, he played an active part in the church community, spending periods as church warden and editor of the parish magazine.

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