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The passing last Fall of Cyril Clarke brought back memories of pleasant and productive interchanges between Liverpool and the Johns Hopkins Hospital over a 20 year period or more beginning in 1957. Cyril was a central figure in those transatlantic collaborations in training and clinical research.
Medical genetics was institutionalised at Johns Hopkins on 1 July 1957, when the multifaceted chronic disease clinic created by Dr J Earle Moore became the base for a medical genetics programme, the Division of Medical Genetics. The Moore Clinic very quickly became synonymous with medical genetics at Johns Hopkins. Although the Medical Genetics Division was a section of the Department of Medicine, its purview encompassed all ages and all specialties, with clinical care, research, and teaching, as in other specialty divisions.
The first visitor to the Moore Clinic from Liverpool was Richard McConnell, who spent a time there during a grand tour in Iowa and elsewhere in the United States, pursuing his interest in ABO/secretor polymorphism in gastric cancer and peptic disease.
Anne and I first met Cyril and Féo in 1956 at the first World Congress of Human Genetics in Copenhagen. The friendship was solidified and the exchange with Baltimore established in our visit to Liverpool in early September 1958, which included a visit to the butterfly laden Clarke ménage. Cyril and Féo had been in Montreal to attend the International Congress of Genetics in August 1958. Cyril confessed serious withdrawal symptoms requiring him to go to the Royal Vic to see outpatients! On that visit, arrangements were firmed up for the first of the Liverpudlians to come to the Moore Clinic, to acquire a BTA (Been to America) degree. That was David A Price Evans, who during his stay in the Moore Clinic did much to initiate the field of pharmacogenetics, by defining the genetics of isoniazid metabolism. Price Evans was Cyril Clarke's successor as Professor of Medicine at Liverpool. During our visit to Liverpool, Malcolm A Ferguson-Smith came down from Glasgow to make arrangements for his sojourn in the Moore Clinic which began in February 1959. At that time, he started what may have been the first hospital based cytogenetics laboratory in the United States.
Over the next 20 years or so, the large number of Liverpudlians who were fellows at Johns Hopkins included Peter Brunt, J Michael Connor, Brian Hanley, Peter S Harper, F Michael Pope, Brian Walker, David Weatherall, and J C Woodrow. Ronald Finn and “Johnny” Woodrow worked particularly with Julius R Krevans pursuing the brilliant hypotheses of Cyril concerning the mechanism and prevention of erythroblastosis fetalis. David Weatherall worked first with Ned Boyer in the biochemical genetics section of the Moore Clinic before establishing clinical connections with Dr C Lockart Conley in the study of haemoglobinopathies and with others in the department of Howard Dintzis in the study of basic mechanisms in the thalassaemias.
In 1976, while Cyril was President of the Royal College of Physicians, Anne and I stayed in his flat at the College. During that time I gave the Lilly Lectures and acquired an honorary MD from the University of Liverpool. It was a rare privilege, in 1977, to receive a Gairdner Award in Toronto at the same time as did Cyril.
In a few words it can be stated that Cyril left his mark on medical genetics by his penetrating and inquisitive mind and by his encouragement of a whole generation of students. Extending from his study of butterflies, he was thinking and speaking about the role of polymorphisms in multifactorial disorders, what we now call complex traits, far ahead of his time.
We at Johns Hopkins are much indebted to Cyril for the able protégés he sent to Baltimore in the formative years of medical genetics here.