Torrid Disease: Memoirs of a Tropical Physician in the late Twentieth Century by Professor G C Cook - Read Online
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This very readable and well illustrated book outlines the medical career of a physician who undertook a series of assignments in tropical countries between 1960 and 1990: Nigeria, Uganda, Zambia, Saudi Arabia and Papua New Guinea. Having thus obtained considerable experience of, and made significant contributions to, ‘medicine in the tropics’, he was later appointed to London’s Hospital for Tropical Diseases, and there saw and contributed to, the formal discipline of tropical medicine (which originated in the late nineteenth century) in the latter years of the twentieth century.

This unique account, outlined in this fascinating narrative, covers more than seven decades, four of which were devoted to tropical diseases, seen in warm climates and also Britain.

Now that the majority of developing countries possess their own medical school and graduates, it is most unlikely that this kind of itinerant and exciting career will be repeated.

About the author: Professor Gordon Cook, DSc, MD, FRCP was born in the early 1930s into a lower middle-class family in South London, where he lived during that decade and much of the Blitz of 1940. During and after the Second World War (1939-45) he underwent a somewhat peripatetic grammar school education, and decided to make medicine his career.

Following junior appointments in medicine, he undertook National Service as a captain in the Royal Nigerian Army at Yaba, Lagos. He subsequently became a Lecturer at Mekerare University College, Uganda, and occupied the Chairs of Medicine at the University of Zambia, Riyadh, (Saudi Arabia) and Papua New Guinea. He was also an invited Visiting Professor at the Universities of Basra and Mosel, Iraq, and Qatar.

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Torrid Disease

Memoirs of a Tropical Physician in the late Twentieth Century

G C Cook, MD, DSc, FRCP, FRCPE, FRACP, FLS

Visiting Professor, University College London

Published as an ebook by Amolibros at Smashwords 2013

AMOLIBROS

About this book

This very readable and well illustrated book outlines the medical career of a physician who undertook a series of assignments in tropical countries between 1960 and 1990: Nigeria, Uganda, Zambia, Saudi Arabia and Papua New Guinea. Having thus obtained considerable experience of, and made significant contributions to, ‘medicine in the tropics’, he was later appointed to London’s Hospital for Tropical Diseases, and there saw and contributed to, the formal discipline of tropical medicine (which originated in the late nineteenth century) in the latter years of the twentieth century.

This unique account, outlined in this fascinating narrative, covers more than seven decades, four of which were devoted to tropical diseases, seen in warm climates and also Britain.

Now that the majority of developing countries possess their own medical school and graduates, it is most unlikely that this kind of itinerant and exciting career will be repeated.

About the author

Professor Gordon Cook, DSc, MD, FRCP was born in the early 1930s into a lower middle-class family in South London, where he lived during that decade and much of the Blitz of 1940. During and after the Second World War (1939-45) he underwent a somewhat peripatetic grammar school education, and decided to make medicine his career.

Following junior appointments in medicine, he undertook National Service as a captain in the Royal Nigerian Army at Yaba, Lagos. He subsequently became a Lecturer at Mekerare University College, Uganda, and occupied the Chairs of Medicine at the University of Zambia, Riyadh, (Saudi Arabia) and Papua New Guinea. He was also an invited Visiting Professor at the Universities of Basra and Mosel, Iraq, and Qatar.

Copyright © G C Cook 2011

First published in 2011 by TROPZAM

11 Old London Road, St Albans, Herts, AL1 1QE

www.tropzam.co.uk

Published electronically by Amolibros 2013

http://www.amolibros.com

The right of G C Cook to be identified as the author of the work has been asserted herein in accordance with the Copyright, Designs and Patents Act 1988.

All rights reserved. This book is sold subject to the condition that it shall not, by way of trade or otherwise, be lent, resold, hired out or otherwise circulated without the publisher’s prior consent in any form of binding or cover other than that in which it is published and without a similar condition including this condition being imposed on the subsequent purchaser.

British Library Cataloguing in Publication Data

A catalogue record for this book is available from the British Library.

This book production has been managed by Amolibros

eBook conversion by Oxford eBooks Ltd.

www.oxford-ebooks.com

For

Jane,

Rosamund, David,

Caroline and Susanna

‘Honour a physician with the honour due unto him for the uses which ye may have of him: for the Lord hath created him.’

Holy Bible: Ecclesiasticus 38: 1

Preface

I was born and ‘brought up’ in the early 1930s in South London, the eldest child of low middle-class parents, both of whom lacked an academic background. I later became one of the first male graduates of the Royal Free Hospital School of Medicine (prior to 1948 the London School of Medicine for Women) in the University of London. Following a relatively successful early academic career, I became a well qualified tropical physician, with a vast experience of both ‘medicine in the tropics’ and the formal discipline (established in 1899) of ‘tropical (or colonial) medicine’.

My tropical career began by accident; I was conscripted into the Royal Army Medical Corps (RAMC) and seconded to the Royal Nigerian Army – subsequently to become a Captain – and Junior Medical Specialist at Yaba, Lagos, Nigeria. Following significant periods in academic medicine in Uganda, Zambia and Saudi Arabia, I made the unwise decision of joining the staff of the London School of Hygiene & Tropical Medicine (LSHTM), with clinical duties at the somewhat ‘run-down’ ‘cottage’ Hospital for Tropical Diseases; there, my immediate colleagues transpired to be a group of individuals with whom I had little, if anything, in common. Their main problem, I suspect, was that (apart from the possible exception of one – H A K Rowland) none had any experience (or interest) in academic medicine. Various promises, including one from the Dean of the LSHTM, failed to materialise. I later worked in Papua New Guinea – but then gravitated back to my London base.

These latter experiences highlight the difficulty in finding a suitable ‘niche’ after stepping out of the ‘rat-race’; Britain has much underlying expertise which is hidden by a rigid establishment system!

At an early age I decided to attempt to make positive personal contributions, rather than ‘sit back’ and simply watch other people’s efforts! From my ‘teens, and probably before that, I was convinced that ambition and perseverance were at least as important as intelligence in achieving something worthwhile.

I have always (despite my interest in ‘tropical’ disease) regarded myself as a general physician. My early background and interest in both ‘medicine in the tropics’ and the formal discipline of tropical (colonial) medicine set out in this book, might be of some interest to posterity; I have thus penned it with that in mind.

I am grateful to my late mother for meticulous preservation of correspondence to her during lengthy spells abroad, to Ruth Richardson for acting as the principal catalyst for the genesis of this autobiography, and Maureen Moran for typing the entire text from my longhand manuscript.

G C Cook

St Albans

December 2009

Contents

Preface

List of Illustrations

1 Ancestors and contemporary relations

2 Early days – 1932-9

3 The Second World War - 1939-45

4 The post-war years – 1946-51

5 Medical education –1951-7

6 Junior appointments – 1957-9

7 Introduction to Tropical Medicine: RAMC and Nigeria – 1960-2

8 London again (1962-5 and 1967-9), and marriage

9 Uganda – 1965-7

10 Zambia – 1969-74

11 Saudi Arabia – 1974-5

12 Brief spell in London : introduction to the Hospital for Tropical Diseases (HTD) and London School of Hygiene and Tropical Medicine (LSHTM)

13 Papua New Guinea – 1978-80

14 London again, the HTD and LSHTM

15Contributions to medical history

Postscript

Appendix I

Appendix II

Appendix III

Appendix IV

Appendix V

Appendix VI

Index

List of Illustrations

Fig 1.1: Charles Francis and Kate Cook (my parents) in the 1960s.

Fig 1.2: Charles William and Frances Cook – (my paternal grandparents).

Fig 1.3: St Mary’s parish church, Hitchin, Hertfordshire in a recent postcard.

Fig 1.4: Tilehouse Street, Hitchin, where several paternal ancestors lived.

Fig 1.5: The tower of St Nicholas’ Church, Stevenage.

Fig 1.6: Stephen Matthew and Kate Kraninger (née Edwards, later Grainger) – my maternal grandparents.

Fig 1.7: Sir James (Wilfred) Cook, FRS (my uncle) when Vice-Chancellor of the University of East Africa.

Fig 2.1: The author with his mother (undated, but probably early 1932).

Fig 2.2: Photograph with John Pincham (1932-present) (left) – a life-long friend.

Fig 2.3: The author with his sister (undated but probably 1937).

Fig 3.1: Photograph of the author – in June 1941.

Fig 3.2: No 13 Spinney Road, Irthlingborough, ‘home’ for most of the war years.

Fig 3.3: Wellingborough Grammar School, Doddington Road.

Fig 3.4: The twelfth century Market Cross – situated in the centre of Irthlingborough.

Fig 3.5: The tower of St Peter’s church, Irthlingborough.

Fig 4.1: The author in October 1947.

Fig 4.2: The author (right) with his brother and sister – at about this time.

Fig 4.3: Raynes Park Grammar School.

Fig 5.1: The Royal Free Hospital School of Medicine (RFHSM), then situated at 8 Hunter Street, Brunswick Square, WC1.

Fig 5.2: HM the Queen (later the Queen Mother) (1900-2002) at the formal opening ceremony in 1951 of a new wing of the RFHSM.

Fig 5.3: The author (right) with his brother and sister at about this time.

Fig 5.4: The Royal Free Hospital then situated in Grays Inn Road.

Fig 6.1: The Royal Northern Hospital.

Fig 6.2: The ‘Old’ Brompton Hospital, Fulham Road.

Fig 6.3: Beachy Head, East Sussex.

Fig 6.4: The ‘Tiger Inn’ at East Dean, East Sussex.

Fig 7.1: National Service intake – Millbank, May 1960.

Fig 7.2: Officers’ Mess – Yaba (a suburb of Lagos), 1961.

Fig 7.3: The author in formal uniform – Lagos, 1961.

Fig 7.4: The author in ‘mess kit’ – Lagos, 1961.

Fig 7.5: The Military Hospital – Yaba 1961.

Fig 7.6: Street scene in Lagos – 1961.

Fig 7.7: Group of Nigerians demonstrating slave-chains, at Badagry – 1961.

Fig 7.8: University Teaching Hospital – Ibadan, February 1961.

Fig 7.9: Plaque on a memorial to Mungo Park and Richard Lander – Jebba, Nigeria, 1961.

Fig 7.10: Hausa horseman – December 1961.

Fig 7.11: A village built on ‘stilts’: Southern Dahomey (now Benin) – 1961.

Fig 8.1: Professor Dame Sheila Sherlock FRS with her husband D Geraint James.

Fig 8.2: The author in 1963.

Fig 9.1: Above: The main administrative building of Makerere University College in 1966.

Fig 9.2: The new Mulago Hospital, Kampala in 1966.

Fig 9.3: Above: Jane with Samuel Kajubi (with whom I studied lactase-deficiency [hypolactasia]).

Fig 9.4: Lake Victoria at Entebbe.

Fig 9.5: Jane at the source of the Nile.

Fig 9.6: Shortly after Rosamund’s birth, in mid 1967.

Fig 9.7: South of Mombasa, Kenya, in July 1967.

Fig 10.1: The Cathedral, Lusaka.

Fig 10.2: The University Teaching Hospital (UTH) undergoing construction – November 1969.

Fig 10.3: The author at Handsworth Park, Lusaka – July 1970.

Fig 10.4: Senior members of the Department of Medicine of the University of Zambia at the time of the first final examination in medicine in 1973.

Fig 10.5: The Victoria Falls (the Mosi-oa-Tunya).

Fig 10.6: An example of the wildlife of Zambia.

Fig 10.7: First day cover (dated 1 May 1973) commemorating the centenary of the death of David Livingstone (1813-73).

Fig 10.8: Caroline, Rosamund and David in December 1973.

Fig 11.1: Scene in Riyadh in 1975.

Fig 11.2: Our modest abode on the edge of the desert, in November 1974.

Fig 11.3: Camel suq in December 1974.

Fig 11.4: Rosamund, David, Caroline and Susanna in March 1975.

Fig 12.1: Frant railway station – April 1976.

Fig 12.2: Sign outside The Hospital for Tropical Diseases, St Pancras Way – in 1977.

Fig 12.3: The author after conferment of a DSc at Senate House, University of London in 1976.

Fig 12.4: 39 Alma Road, St Albans – home from 1976 until 1989.

Fig 12.5: The Cathedral and Abbey Church of St Alban – 1976.

Fig 12.6: Gorhambury House, St Albans in 1977.

Fig 13.1: View of the Torres Strait from Port Moresby.

Fig 13.2: Advertisement for crocodile steaks at the Kokoda Trail Hotel.

Fig 13.3: Our stilted residence in PNG.

Fig 13.4: The Sydney Harbour Bridge.

Fig 13.5: Example of a PNG artefact – from the Sepik region.

Fig 13.6: The author on his 48th birthday (17 February 1980).

Fig 14.1: A reception at a medical conference, Portugal, June 1989.

Fig 14.2: The author, when President of the Royal Society of Tropical Medicine and Hygiene in July 1994.

Fig 14.3: The author with Sir Ian McGregor FRS and the Princess Royal at Manson House, 26 Portland Place on 3 October 1994.

Fig 14.4: The author talking to the crime-writer, P D James (Baroness James of Holland Park) at the Medical Society of London in November 1998.

Fig 14.5: 11 Old London Road, St Albans. A late Georgian property, built some time between 1810 and 20.

Fig 15.1: The Hugh L’Etang Prize had just been presented by Dr J M H Moll (Editor of the Journal of Medical Biography) at the Royal Society of Medicine. The portrait on the right is of Erasmus Darwin.

Fig 15.2: The author as President of the Osler Club of London.

Fig 16.1: Jane in 1981; photograph taken shortly after returning to St Albans from Papua New Guinea.

Fig 16.2: The author with Dr Clinton Manson-Bahr (left) in May 1991. The occasion was a reception to mark forty years since the opening of the HTD at St Pancras.

Fig 16.3: The author meeting H M The Queen at Apothecaries Hall in 2000.

1

Ancestors and contemporary relations

My parents were Charles Francis Cook (1902-83) and Kate, née Kraninger (later Grainger) Cook (1904-78) (see fig 1.1).

My father (usually known as Frank) who was born on 11 September 1902, had a brother (see below) and sister; he was a metallurgist and later Works Manager and Company Director. After elementary school in Fulham, he attended evening classes at the Northampton Polytechnic (now City University) in London, and obtained a City of Guilds diploma. In the Great Depression of the early 1930s, when the politics of Oswald Mosley (1896-1980) were causing considerable concern in east London, during which he was briefly unemployed, he set up as a shop-keeper in Earlsfield; however, this enterprise failed; he later worked at the Savoy Hotel and most of his subsequent career took place at the British Syphon Company, Islington; then during the second World War, Irthlingborough, and following the war, Eastbourne. As a child, he had suffered from rickets (for which callipers were apparently required) and attended the Children’s Hospital at Tite Street, Chelsea. He died suddenly at his home in Petersfield – probably as a result of a myocardial infarct. He was a freemason (albeit not a very enthusiastic one) at the John Pyel Lodge, Irthlingborough.

My mother (usually known as Cis) who was born on 15 June 1904, came from a family of ten children (eight boys and two girls). She had trained in early life as a book-keeper. In later years she suffered from severe rheumatoid arthritis, requiring corticosteroids at high dosage; as a result, she became osteoporotic and almost certainly died of an iatragenic illness. Like both my mother and youngest daughter, I have suffered from acute migraine attacks (with an aura) for most of my life.

My parents married at St Matthews Church, Fulham, on 6 September 1930.

Fig 1.1: Charles Francis and Kate Cook (my parents) in the 1960s. My mother was already suffering from severe rheumatoid arthritis

Fig 1.2: Charles William and Frances Cook (my paternal grandparents). This photograph was probably taken at the time of their engagement.

The Cooks (and Walls)

My paternal grandparents were Charles William Cook (1865-1947), who was born on 4 January 1865 at Hitchin,¹ Hertfordshire, and Frances Cook (née Wall) (1873-1962), born on 17 July 1873 (see fig 1.2). I remember both well. I think they had met ‘in service’ in Hertfordshire. My grandfather – a bald man when I knew him – who suffered from advanced Parkinson’s disease (as did my father in later life) and whose memory was beginning to fail, rode a heavy bicycle until he was over 80 years old. My grandmother was ‘stone deaf’ (I assume she had suffered middle ear infections in earlier life) but remained alert and highly intelligent until 89 years old; she had had no recurrence of a breast carcinoma (for which she had had a mastectomy in the 1930s or 40s).

Charles William (described in his marriage certificate as a Coachman of St Paul’s, Southwark) and Frances, daughter of Aaron Wall (1840-1906) (see below), a carpenter and wheelwright of Stockton, Kimbolton, and Sarah Jane Jones of Eardisley, Herefordshire, were married at St James Church, Kimbolton, Herefordshire on 25 November 1899. Charles William died at 68 Melrose Avenue, Mitcham, of ‘senile myocarditis’ and heart failure, on 30 June 1947 (he was described on his death certificate as a retired private chauffeur), and Frances at a nursing home at 11 Lewes Road, Eastbourne, Sussex on 25 March 1962 of ‘myocardial degeneration’ and ‘coronary atheroma’; she had previously been diagnosed as suffering from ’senile diarrhoea’. My grandmother (Frances) was an excellent cook, and I well recall (I think it was in 1947) that she stayed with us over Christmas and cooked the Christmas lunch – a highlight of which was the plum pudding, soaked in brandy and which she brought into the dining room ‘blazing’!

My paternal great-grandfather, John Cook (born 1836/7) was one of three siblings; he married Charlotte French, and in his teens was living at Church Yard, to the west end of St Mary’s (see fig 1.3) and later (in 1881) Tilehouse Street (see fig 1.4). He had probably been baptised at Hitchin (presumably at the parish church) in 1837 – the year of Queen Victoria’s accession to the throne. He is variously described as a bricklayer’s labourer and bricklayer, who had been born in Hitchin. My paternal great-grandmother, Charlotte Cook (see above) (born 1834/5) is described as a straw plaiter of Preston, a village about three miles south of Hitchin. John was the son of William Cook – an ostler and labourer. John and Charlotte were married in Hitchin Parish Church on 4 April 1861.

Fig 1.3: St Mary’s parish church, Hitchin, Hertfordshire in a recent postcard. It almost certainly played an important rôle in the lives of several Cook antecedents.

Fig 1.4: Tilehouse Street, Hitchin, where several paternal ancestors lived.

Fig 1.5: The tower of St Nicholas’ Church, Stevenage, which must have been well known to several paternal ancestors.

The parents of Aaron Wall (father of Frances) probably came originally from Gorsty Hill, Staffordshire but moved to Kimbolton; they had probably married on 21 February 1805, but possibly 1807.

My paternal great-great-grandparents also lived in Hitchin – in the 1830s. They were William (an ostler, labourer and gardener) and Ann Cook (née Game); they were married at St Mary’s Church, Hitchin on 8 November 1823, and lived at Church Yard, Hitchin. William, a groom, had been born in Stevenage about 1800/1 and Ann came from the nearby village of Weston and was of a similar age. He was the son of William (baptised 12 July 1761) and Mary Cook (née Rance) (my great-great-great-grandparents) and had married at St Nicholas Church, Stevenage (see fig 1.5) on 12 May 1788.

My great-great-great-great-grandfather was probably James Cook (? – 1768) (a carrier), who was born in 1735/6, and had married Ann(e) Deards (daughter of James Deards) in Stevenage (presumably also at St Nicholas’ Church) on 4 April 1761; he was, however, buried on 4 January 1788. Ann might have remarried.

Fig 1.6: Stephen Matthew and Kate Kraninger (née Edwards, later Grainger) – my maternal grandparents. Photograph undated, but probably taken in the 1890s.

The Kraningers (Graingers)

My mother always ‘steered clear’ of revealing anything about her ancestry; what I know was gleaned from other sources. My maternal grandparents were Stephen Matthew Kraninger (1863/4-1917) and Kate Kraninger (née Edwards) (1869-1920) (see fig 1.6) – who originated from Warwickshire (see below) – and they married at the Parish Church, Brighton, on 8 April 1891. Kate changed the family name to Grainger, which Stephen had unsuccessfully attempted (probably in 1914), by deed-poll on 29 April 1917 – following the death of her husband. Stephen is described as being a waiter at the Royal York Hotel, the son of Joseph Kraninger, a farmer of Austria (probably Vienna), and Kate, daughter of Richard Williams (who according to one document, had a different surname from her own), a beer retailer. Stephen, a white-haired Austrian (who almost certainly, although never proved, had some Jewish ancestry, despite the fact that he is said to have sung in a Christian church choir – presumably Roman Catholic – near Vienna) according to one reliable eye-witness, died at the Cancer Hospital in Fulham Road as a result of an oesophageal carcinoma on 29 April 1917. Kate, born on 30 August 1869 at Tindall Street, Kings Norton, Warwickshire, died suddenly on 18 March 1920 at Snowbury Road, Fulham, the cause of death being recorded as being due to ‘acute congestion of the lungs’.

Their children (my mother, an aunt and eight uncles) were born at various abodes of their parents: 23 Arnold Street, Brighton (1892), 12 Elder Street, Brighton (1893-8), 156 Kings Cross Road, London WC (1898) and 131 Hazelbury Road, Fulham SW (1900-09). The Kraningers subsequently removed to 1 Snowbury Road, Fulham, SW6. The youngest of my maternal uncles was Leonard Kraninger (Grainger) – who from reliable descriptions suffered from achondroplasia.² I well recall him telephoning one Christmas Day (possibly 1946) and asking whether he could visit us later that day; my father, I remember, told him that there were 364 other days in the year, and he would not be welcome on Christmas Day!

My maternal great-grandparents were: Richard Edwards (1828?-90) (possibly from Weston, Somerset) variously described as a beer retailer, domestic servant and groom, and farm bailiff, and Ellen Cowlishaw (1829-?); they were married at St Martin’s Church, Birmingham on 5 February 1854. Richard was the son of Robert Edwards, a labourer (see below) who probably died on 13 October 1890 of a ‘diseased heart and dropsy’, of Kings Norton, Warwickshire.

My maternal great-great-grandfathers have as yet to be identified with certainty, although their names are known to have been Robert Edwards and Edward Cowlishaw respectively – both of them described in contemporary documents as labourers.³

Contemporary relations

I have a sister, Margaret Jean (1933 – present) – who has recently survived a severe myocardial infarct – and a brother Derek Ian (1935 – present); I well recall the latter’s birth; grandmother Cook (see above) assisted with the birth, and stayed at our house in Stuart Road (see Chapter 2) – where the event took place. The usual method of sterilisation of obstetric materials in those days was by baking in a gas oven! I still recall suggesting to my sister, who was in a cot (when we awoke), that the squawks must emanate from a baby brother or sister.

I was significantly influenced intellectually by my paternal uncle (see below) and to a lesser extent, his wife, my aunt (Elsie) – who were always ‘on good terms’ with my parents. Of Dorothy (known by her two brothers as ‘Doll’) and her family, I know little.

Although my mother had eight surviving siblings (one brother had died in infancy, and another was killed in the Great War – see below), I only knew two well! Nellie (1893 – ?) (my mother’s sole sister) had emigrated to Pemberton, near Perth, Western Australia following marriage; Charles (1895-95) died in infancy, and George (1896-1915) was killed in action at Loos (on 28 September 1915).

The two maternal uncles whom I knew well were: Stephen (usually known as Steve) (1892-1974) – who had served as a private in the Great War – and Walter (known as Wally) (1901-?). Frederick (1899-1987), Arthur (1900 – ?), Charles (interestingly, baptised with the same name as one who died in infancy (1906 – 95), and Leonard (1908 – ?) I hardly knew at all, although on two occasions I had met Charles briefly, and on a single one, Frederick. Stephen lived at Girdwood Road, Southfields (in close proximity to the Royal Hospital and Home for Incurables (later the Royal Hospital for Neuro-disability) – a history of which I was to write later (see chapter 15) – ie within walking distance of my parents’ house in Wimbledon Park – see Chapter 2); his wife was named Mildred (usually known as ‘Milly’ – a somewhat ‘delicate’ woman). Stephen worked for a firm of biscuit and cake manufacturers – MacFarlane Lang, which enabled him to host expansive tea parties on ‘Boxing Day’ every year (see Chapter 2) – well retained in my memory. Wally and his wife Winifred (usually known as ‘Winny’) also lived nearby – in Southfields – and always kept in close contact. I remember them being particularly generous – especially at Christmas. Wally, who had in his younger days sailed to Australia in search of fortune, I recall, rented a bungalow for us – I think at Worthing – when we three children were convalescing from one of the childhood fevers, probably measles, in I suspect 1938.

Fig 1.7: Sir James (Wilfred) Cook, FRS (my uncle) when Vice-Chancellor of the University of East Africa.

Sir James Wilfred Cook FRS (1900-75)

Without doubt, my most distinguished relation was my paternal uncle James – usually known as Jim