Robert Daniel Lawrence
Encyclopedia
Dr. Robert Daniel Lawrence (1892–1968) M.A., MB ChB.(Hons), MD, FRCP, LLD, was a British physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

.

Dr RD Lawrence, better known as Robin Lawrence, who was diabetic for the last 47 years of his life and spent this time caring professionally for diabetic patients, and was for much of this time the most famous diabetic in Britain
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...

, is best known and remembered as founder of The British Diabetic Association.


He was born in Aberdeen
Aberdeen
Aberdeen is Scotland's third most populous city, one of Scotland's 32 local government council areas and the United Kingdom's 25th most populous city, with an official population estimate of ....

 on 18 November 1892 at 10 Ferryhill Place, a four-storied granite terraced dwelling in a quiet tree-lined street in what was then an affluent middle-class area of the city. He was the second son of Thomas and Margaret Lawrence. His father was a prosperous brush manufacturer, his firm supplying all the brushes to Queen Victoria
Victoria of the United Kingdom
Victoria was the monarch of the United Kingdom of Great Britain and Ireland from 20 June 1837 until her death. From 1 May 1876, she used the additional title of Empress of India....

 and her heirs at Balmoral
Balmoral Castle
Balmoral Castle is a large estate house in Royal Deeside, Aberdeenshire, Scotland. It is located near the village of Crathie, west of Ballater and east of Braemar. Balmoral has been one of the residences of the British Royal Family since 1852, when it was purchased by Queen Victoria and her...

. When aged 10, the family moved to a larger more imposing newly built granite building, 8 Rubislaw Den North, then on the outskirts of the town and now the most prestigious housing area in the city. He was within five minutes cycling distance of the Aberdeen Grammar School
Aberdeen Grammar School
Aberdeen Grammar School, known to students as The Grammar is a state secondary school in the City of Aberdeen, Scotland. It is one of twelve secondary schools run by the Aberdeen City Council educational department...

 which he attended from 1900-1909. He had a good scholastic record but also excelled at sport. In his later years there he represented the school at rugby
Rugby football
Rugby football is a style of football named after Rugby School in the United Kingdom. It is seen most prominently in two current sports, rugby league and rugby union.-History:...

 and cricket
Cricket
Cricket is a bat-and-ball game played between two teams of 11 players on an oval-shaped field, at the centre of which is a rectangular 22-yard long pitch. One team bats, trying to score as many runs as possible while the other team bowls and fields, trying to dismiss the batsmen and thus limit the...

 and won prizes for swimming
Swimming (sport)
Swimming is a sport governed by the Fédération Internationale de Natation .-History: Competitive swimming in Europe began around 1800 BCE, mostly in the form of the freestyle. In 1873 Steve Bowyer introduced the trudgen to Western swimming competitions, after copying the front crawl used by Native...

. Throughout his school years his name featured regularly for different events at the annual school sports including in 1907, 2nd prize for the bizarre event "Sword Feats on Bicycle"!

He matriculated aged 18 and went to Aberdeen University and took an M.A. in French and English. After graduation, he briefly worked in an uncle's drapery shop in Glasgow
Glasgow
Glasgow is the largest city in Scotland and third most populous in the United Kingdom. The city is situated on the River Clyde in the country's west central lowlands...

 but gave this up after just a few weeks, returning to Aberdeen where he enrolled back at Aberdeen University to study medicine
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....

. He had a brilliant undergraduate career winning gold medals in Anatomy (2), Clinical Medicine and Surgery and graduated 'with honours' in 1916. During his second year, as was possible at this time, on the advice of his anatomy
Anatomy
Anatomy is a branch of biology and medicine that is the consideration of the structure of living things. It is a general term that includes human anatomy, animal anatomy , and plant anatomy...

 professor he sat and passed the primary F .R.C.S. examination in London
London
London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...

. He gave up rugby when a student, but represented the University at both hockey
Hockey
Hockey is a family of sports in which two teams play against each other by trying to maneuver a ball or a puck into the opponent's goal using a hockey stick.-Etymology:...

 and tennis
Tennis
Tennis is a sport usually played between two players or between two teams of two players each . Each player uses a racket that is strung to strike a hollow rubber ball covered with felt over a net into the opponent's court. Tennis is an Olympic sport and is played at all levels of society at all...

. He was also President of the Students' Representative Council.


On graduation he immediately joined the R.A.M.C.
Royal Army Medical Corps
The Royal Army Medical Corps is a specialist corps in the British Army which provides medical services to all British Army personnel and their families in war and in peace...

 and after six months home service, served on the India
India
India , officially the Republic of India , is a country in South Asia. It is the seventh-largest country by geographical area, the second-most populous country with over 1.2 billion people, and the most populous democracy in the world...

n Frontier until invalided home in 1919 with dysentery
Dysentery
Dysentery is an inflammatory disorder of the intestine, especially of the colon, that results in severe diarrhea containing mucus and/or blood in the faeces with fever and abdominal pain. If left untreated, dysentery can be fatal.There are differences between dysentery and normal bloody diarrhoea...

 and was discharged with the final rank of Captain. After a few weeks convalescing at home and fishing, he went to London and obtained the post of House Surgeon in the Casualty Department at King's College Hospital
King's College Hospital
King's College Hospital is an acute care facility in the London Borough of Lambeth, referred to locally and by staff simply as "King's" or abbreviated internally to "KCH"...

. Six months later, being now accepted as a "King's Man", he became an assistant surgeon in the Ear, Nose and Throat Department. Shortly afterwards, while practising for a mastoid operation
Mastoid process
The mastoid process is a conical prominence projecting from the undersurface of the mastoid portion of the temporal bone. It is located just behind the external acoustic meatus, and lateral to the styloid process...

 on a cadaver, he was chiselling the bone when a bone chip flew into his right eye setting up an unpleasant infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...

. He was hospitalised but the infection failed to settle and he was discovered to have diabetes. At his age at this time this represented a death sentence. He was however initially controlled on a rigid diet and the eye infection settled but left permanently impaired vision in that eye. He abandoned thoughts of a career in surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

 and worked in the King's College Hospital Chemical Pathology Department under a Dr G A Harrison. Despite his gloomy prognosis
Prognosis
Prognosis is a medical term to describe the likely outcome of an illness.When applied to large statistical populations, prognostic estimates can be very accurate: for example the statement "45% of patients with severe septic shock will die within 28 days" can be made with some confidence, because...

 and ill-health he managed to conduct enough research to write his thesis entitled "The Estimation of Diastase in Blood and Urine and its Diagnostic Significance", for which he was awarded his M.D. by Aberdeen University in 1922. A little later, in the expectation that he had only a short time to live, and not wishing to die at home causing upset to his family, he moved to Florence
Florence
Florence is the capital city of the Italian region of Tuscany and of the province of Florence. It is the most populous city in Tuscany, with approximately 370,000 inhabitants, expanding to over 1.5 million in the metropolitan area....

 and set up in practice there. In the winter of 1922-23 his diabetes deteriorated badly after an attack of bronchitis
Bronchitis
Acute bronchitis is an inflammation of the large bronchi in the lungs that is usually caused by viruses or bacteria and may last several days or weeks. Characteristic symptoms include cough, sputum production, and shortness of breath and wheezing related to the obstruction of the inflamed airways...

 and the end of his life seemed nigh. He was however saved by the discovery of insulin
Insulin
Insulin is a hormone central to regulating carbohydrate and fat metabolism in the body. Insulin causes cells in the liver, muscle, and fat tissue to take up glucose from the blood, storing it as glycogen in the liver and muscle....

 in Toronto
Toronto
Toronto is the provincial capital of Ontario and the largest city in Canada. It is located in Southern Ontario on the northwestern shore of Lake Ontario. A relatively modern city, Toronto's history dates back to the late-18th century, when its land was first purchased by the British monarchy from...

, Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...

, by Banting, Best, Collip and Macleod in early 1922. Supplies were however initially in short supply and slow to reach this country, but in May 1923 Harrison cabled Lawrence - "I've got insulin - it works - come back quick". By this time Lawrence was weak and disabled by peripheral neuritis
Peripheral neuropathy
Peripheral neuropathy is the term for damage to nerves of the peripheral nervous system, which may be caused either by diseases of or trauma to the nerve or the side-effects of systemic illness....

 and with difficulty drove across the continent and reached King's College Hospital on 28 May 1923. After some preliminary tests he received his first insulin injection on 31 May. His life was saved. He spent two months in hospital recovering and learning all about insulin and then was appointed Chemical Pathologist at King's College Hospital.

He was to devote the rest of his life to the care and welfare of diabetic patients. He developed one of the earliest and largest diabetic clinics in the country and in 1931 was appointed assistant physician-in-charge of the diabetic department at King's College Hospital, becoming full physician-in-charge in 1939. He also had a large private practice. He wrote profusely on his subject and his books "The Diabetic Life" and "The Diabetic ABC" did much to simplify treatment for doctors and patients. The Diabetic Life first published in 1925 became immensely popular extending into 14 editions and was translated into many languages. He published widely on all aspects of diabetes and its management, producing some 106 papers either alone or with colleagues, including important publications on the management of diabetic coma
Diabetic coma
Diabetic coma is a reversible form of coma found in people with diabetes mellitus. It is a medical emergency.Three different types of diabetic coma are identified:#Severe diabetic hypoglycemia...

, on the treatment of diabetes and tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...

 and on the care of pregnancy
Pregnancy
Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...

 in diabetics.

In 1934 he conceived the idea of an association which would foster research and encourage education and welfare of patients. To this end a group of doctors and diabetics met in the London home of Lawrence's patient, H.G. Wells, the scientist and writer, and so the Diabetic Association was formed. When other countries followed suit it became the British Diabetic Association (the B.D.A.). Lawrence was Chairman of the Executive Council from 1934–1961 and Hon. Life President from 1962. His enthusiasm and drive ensured the life and steady growth of this association which soon became the voice of the diabetic population and constantly sought to promote the welfare of diabetics and there are now active branches through the country. He was also a prime mover in production of "The Diabetic Journal" (forerunner of Balance), the first issue of which appeared in January 1935. Many articles thereafter were contributed by himself anonymously [9]. He, with his friend and colleague Joseph Hoet, were also the main proponents in founding the International Diabetes Federation
International Diabetes Federation
The International Diabetes Federation is a worldwide alliance of some 200 diabetes associations in more than 160 countries, who have come together to enhance the lives of people with diabetes everywhere. For over 50 years, IDF has been at the vanguard of global diabetes advocacy...

 and he served as their first president from 1950-1958. At their triennial conferences, Lawrence's appearance was always greeted with acclaim.

He received other honours. He was Oliver-Sharpey lecturer at the R.C.P.
Royal College of Physicians
The Royal College of Physicians of London was founded in 1518 as the College of Physicians by royal charter of King Henry VIII in 1518 - the first medical institution in England to receive a royal charter...

 London in 1946, the subject of the lecture being one of the earliest descriptions and detailed study of the rare condition now known as Lipoatrophic Diabetes
Lipoatrophic diabetes
Lipoatrophic diabetes is a type of diabetes mellitus presenting with severe lipodystrophy in addition to the traditional signs of diabetes....

. He was recipient of the Banting Medal of the American Diabetes Association
American Diabetes Association
The American Diabetes Association is a United States-based association working to fight the consequences of diabetes, and to help those affected by diabetes...

 the same year; Banting Lecturer of the B.D.A. in 1949 and in 1964 Toronto University conferred on him its L.L.D. "honoris causa". Charles Best, then professor of physiology
Physiology
Physiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...

 in Toronto, was probably the proposer for this honour as he had met and become friendly with Lawrence when doing postgraduate research in London with Sir Henry Dale
Henry Hallett Dale
Sir Henry Hallett Dale, OM, GBE, PRS was an English pharmacologist and physiologist. For his study of acetylcholine as agent in the chemical transmission of nerve impulses he shared the 1936 Nobel Prize in Physiology or Medicine with Otto Loewi.-Biography:Henry Hallett Dale was born in Islington,...

 and A. V. Hill
Archibald Hill
Archibald Vivian Hill CH OBE FRS was an English physiologist, one of the founders of the diverse disciplines of biophysics and operations research...

 in 1925-28. They remained lifelong friends meeting regularly when in each other's country. Best was also present at Lawrence's wedding to Doreen Nancy Batson on 7 September 1928. Dr and Mrs. Lawrence had three sons.

Almost immediately after his retirement
Retirement
Retirement is the point where a person stops employment completely. A person may also semi-retire by reducing work hours.Many people choose to retire when they are eligible for private or public pension benefits, although some are forced to retire when physical conditions don't allow the person to...

 he suffered a stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...

 but his spirit remained indomitable and he continued seeing private patients to the end. His last publication was an account of how hypoglycaemia exaggerated the signs of his hemiparesis
Hemiparesis
Hemiparesis is weakness on one side of the body. It is less severe than hemiplegia - the total paralysis of the arm, leg, and trunk on one side of the body. Thus, the patient can move the impaired side of his body, but with reduced muscular strength....

. Although he preached strict control of diabetes for his patients, he did not keep to a strict diet himself taking instead supplementary shots of soluble insulin as he judged he needed them. He died on 27 August 1968 aged 76.


He is commemorated by an annual Lawrence lecture given by a young researcher in the field of diabetes to the Medical & Scientific Section of the B.D.A. which he also helped found and by the Lawrence Medal awarded to patients who have been on insulin for 60 years or more.RD Lawrence Lecture The B.D.A. remains his lasting memorial.


Article posted by Mrs. Jane Lawrence who is currently writing the biography of Dr. RD Lawrence with a team of medical specialist. The above text was contributed with his permission by:
M.J. Williams Rtd. Consultant Physician Consultant-in-Charge Aberdeen Diabetic Clinic 1983-1994
The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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