Psychiatric Bulletin (2007) 31: 195. doi: 10.1192/pb.bp.107.014605
© 2007 The Royal College of Psychiatrists
Sir Martin Roth
First President of the Royal College of Psychiatrists
Eugene Paykel
Sir Martin Roth, first President of the Royal College of Psychiatrists,
Emeritus Professor of Psychiatry in Cambridge and the most eminent British
psychiatrist of his generation, died on 26 September 2006 at the age of
88.
Martin Roth was born in Budapest and came to London with his parents at the
age of 8, to live initially in the East End. He was educated at the Davenant
Foundation School, an East End grammar school with a long history of
excellence. He entered St Mary’s Hospital Medical School in 1937,
qualifying in 1942 and working in Park Prewitt Hospital, then a military
hospital. He obtained the MRCP in 1944 and his MD in 1945. He trained in
neurology at Maida Vale Hospital, also obtaining some neuropathological
experience, and in psychiatry at the Maudsley. He then worked at Crichton
Royal Hospital with Willi Mayer-Gross, an eminent German psychiatrist who was
a refugee from Nazi persecution, and was invited to be an author of
Clinical Psychiatry (Mayer-Gross, Slater & Roth), which became a
standard textbook. It was translated into five languages and ran three
editions in the 1950s and 1960s.
He moved to Graylingwell Hospital in 1950 as Director of Clinical Research,
a post that was the precursor of Director of the Medical Research Council
unit. He became Professor of Psychiatry in Newcastle in 1956, and under his
leadership the department became one of the most highly regarded in this
country, with a number of colleagues who went on to chairs, including three in
Australia. He moved to be the Foundation Professor of Psychiatry in Cambridge
in 1977, to a department that was initially very small and under-resourced
both by the University and the National Health Service. He built up a strong
base of research, which has since facilitated development of a much larger
department (receiving five stars in the Research Assessment Exercise). He
retired in 1985, but remained much engaged in research and passionate about
research issues until his eighties. The passion could be reflected in a
tendency to overrun his allotted time in distinguished guest lectures at
international conferences.
Sir Martin’s research was clinical. He was particularly interested in
psychiatric classification. His studies were over a range of disorders,
including depression and anxiety disorders, but his pathfinding work was in
disorders of the elderly. In an early study at Graylingwell Hospital, he
established the modern nosology in what had earlier been viewed as a single
unitary degenerative illness, showing that five types of disorder with
different features and prognoses could be separated: senile psychosis
(Alzheimer’s disease), arteriosclerotic dementia, paraphrenia,
depression and confusional states. A number of later studies replicated and
extended this work. In Newcastle he collaborated with neuropathologists to
explore quantitatively the role of plaques and tangles in Alzheimer’s
disease. In Cambridge he established a collaboration with a Nobel
prize-winning molecular biologist, Sir Aaron Klug (later President of the
Royal Society) to examine neurofibrillary tangles and established the
structure of the paired helical filaments of which they are composed, and that
a major constituent is an abnormal isoform of tau protein. Indirectly this has
also led to much further work by others in Cambridge on abnormal protein
depositions in brain diseases. His academic and research standing were
recognised by numerous highly distinguished prizes, honorary degrees, visiting
professorships, memberships of advisory committees and of the Medical Research
Council. He was knighted in 1972. He was particularly proud when he became one
of the small band of psychiatrists to have been elected FRS, in 1996, for his
pioneering work in old age
psychiatry.
He was elected first President of the Royal College of Psychiatrists in
1971, to take office in 1972. The foundation of the College had been opposed
by some senior psychiatrists and by junior doctors concerned at a
proliferation of potentially difficult examinations. There was unhappiness
regarding the candidates proposed by the Council of the precursor
organisation, the Royal Medico-Psychological Association. Martin Roth was
proposed by a group of members and was elected comfortably. Some younger
objectors to the College were present at the inaugural meeting, but in a
memorable inaugural address Martin Roth won them all round. He told a long
anecdote about the formidable competitive examination for the civil service in
old imperial China. More than 10 000 candidates were gathered for days in a
sealed venue, from which none could leave. Some died, including examiners, and
they would be lowered over the walls. Blank papers and copies of last wills
and testaments were not uncommonly handed in by candidates whose minds had
snapped under the stress. One Grand Examiner became unhinged, tore up the
papers and had to be bound to his chair. As this cautionary tale proceeded,
the good nature of the narrator became increasingly apparent. He began to
smile and then to laugh. The audience joined in and laughed long and loud. The
atmosphere changed magically and all then proceeded easily and well.
Sir Martin’s contributions to the College thereafter were immense.
Under his leadership the College established a regime of inspection of
training posts, to ensure that trainees received the training to which they
were entitled. Trainees received a voice in College affairs. The College
achieved its proper influence with Government and among other Royal Medical
Colleges. His untiring work with donors and persons of influence ensured the
acquisition of the building at 17 Belgrave Square which became the
College’s permanent home.
Sir Martin was a man of considerable gravitas, which was combined with
warmth and an interest in people. His portrait which hangs in the College
conveys his essential qualities well. He was a gifted orator, with a
repository of memorable anecdotes and quotations. Behind this exterior was a
happy family man and a gifted musician who considered a professional career,
and continued to play the piano and be absorbed in classical music in his
eighties. He married, in 1945, Constance Heller, an equal in every way. Lady
Roth provided great support through a long and happy marriage and devoted care
in the last few years of his increasing frailty. Among their three daughters,
one is a psychiatrist and another a psychologist.
