Paul Watkins pays tribute to the late Dr Bill Frankland, 'Grandfather of Allergy', with assistance from Prof Andrew Rice.

Dr A W ‘Bill’ Frankland MBE, DM, FRCP

19 March 1912–2 April 2020

The death of Dr Bill Frankland marks the passing of an era in the history of St Mary’s Hospital and Medical School, being the last man alive to have qualified from St Mary’s before the Second World War.

Early Life

Born in 1912 at Little Common in Sussex,  the son of  the Rev Henry Frankland  and his wife Rose,  Bill was the younger of twin boys, and the smaller; he weighed just 3lb 1oz. The chances of survival were deemed low. But survive he did, and two years later his family moved to Dacre, Cumberland where his father served as Vicar of St Andrew’s Church. From here Bill saw his father leave to -and return from-  the Great War, serving as a chaplain in France and Egypt. It was here that Bill first developed symptoms of hayfever, a condition which would occupy much of his professional life and affect him personally for almost a century. Bill’s strong intellectual curiosity caused him to muse as to why his twin, Jack, never developed the condition.

After schooling at St Bees, Bill matriculated at The Queen’s College Oxford in 1930, having gained a Thomas Exhibition on entry. He graduated BA in 1934, having been taught by such luminaries as Sir Charles Sherrington, a young John Eccles and the anatomist Wilfred Le Gros Clark. A sportsman, he competed against the record-breaking Olympic gold medallist, and future St Mary’s student, Jack Lovelock. At the time of his death he was  Oxford’s oldest alumnus and had been elected an Honorary Fellow of The Queen’s College in 2012.

Training at St Mary’s

In 1934 Bill  commenced his clinical training St Mary’s Hospital Medical School, in which there were two notable and powerful men, Dr Charles Wilson, the Dean and Sir Almroth Wright, Professor of Bacteriology. Both had been highly influential in obtaining funds after the Great War to address the parlous state of both St Mary’s buildings and finances. Bill’s first encounter with clinical medicine was, in fact, a ward round given by the eminent physician and Home Office pathologist, Sir William Wilcox.

During Bill’s time as a student he witnessed several remarkable developments. In 1936, at Queen Charlotte’s Hospital he saw the first use of the antibacterial Prontosil rubrum by Leonard Colebrooke in women suffering from puerperal sepsis. The result was a reduction in mortality from 22% to about 5%. He attended the Inoculation Department where everyone was expected to assemble for tea and listen to Sir Almroth Wright (‘The Old Man’) speak. Although all keen to hear of his scientific work they were repeatedly presented with a lecture on misogyny. Bill also received lectures from Professor Alexander Fleming (‘Flem’) and was told not only of the discovery of penicillin, but also the prediction (made at least eight years before its clinical use) that bacteria would develop resistance to this antibacterial substance.

It was in 1937, as a senior student, that Bill visited the Eye Department and encountered a young blonde orthoptist with ‘beautiful blue eyes.’ The lady was Miss Pauline Jackson, and in 1940 they were engaged, marrying in May 1941. They subsequently enjoyed over 60 years of marriage and had four children: three daughters and a son.

On graduation in 1938, Bill was appointed as houseman to Sir Charles Wilson (Later Lord Moran). There was no salary, but hospital accommodation was provided. Bill’s  room for the year had previously served as a laboratory  where Fleming had discovered penicillin in 1928.

Service in the War

With the gathering storm clouds of war, Bill joined the military medical services as a Civilian Medical Practitioner on 1 September 1939 and was posted to Tidworth. It was here that he published his first paper, ‘On the Dangers of Sulphapyridine.’ Commissioned into the RAMC in November 1939, he proudly wore the Sam Browne that had belonged to his father in the Great War. In 1941, after a two-day course in tropical medicine at Millbank, he was posted east, arriving in Singapore a week before the tumultuous events of Pearl Harbour. Based at Tanglin Military Hospital he avoided a posting to Alexandra Hospital (and probable certain death) by the toss of a coin. At Tanglin his responsibilities included the medical care of four Japanese soldiers who had been taken prisoner early in the fighting. On 13 February 1942 he was responsible for ensuring the safe passage of many nurses from Singapore Cricket Club to the docks in order for them to escape the fast deteriorating situation.

After the fall of Singapore, he was imprisoned at Roberts Barracks at Changi, caring for the sick and injured.  The following year he led a British rugby team in victory over the Australians, the latter being captained by Lieutenant Colonel EE ‘Weary’ Dunlop, who Bill noted was wearing the distinctive St Mary’s Hospital rugby shirt.  Although at one time destined for the Burma-Thai Railway, Bill was sent by his captors to be the medical officer on Blakang Mati, (now known as Sentosa) the only medical officer for some 300 men on what became known as ‘Hell Island.’ Faced with starvation and the ravage of diseases, combined with the cruelty of their captors, Bill somehow ensured that not one of his patients died over the ensuing two years. He, himself, was on the receiving end of severe brutality, at one time almost being bayoneted through the chest.

August 1945 brought liberation after the explosion of two Atom bombs, he was later to describe how they ‘saved my life.’  He still had work to do, caring for hundreds of sick men once back on Singapore Island. Finally, he was able to return home in October 1945 and decided to put the awful experiences aside.

A Pioneer of Clinical Allergy

Returning to a career in hospital medicine at St Mary’s he initially worked for John Freeman in the Allergy Department and Gordon Mitchell-Heggs and Jack Suchet in the Dermatology Department. Before long his interests moved to full-time work in allergy. From 1953-55 he was Clinical Assistant to Sir Alexander Fleming, and had to meet with his boss every morning, without fail, at 10 o’clock. He recalled how Fleming never talked about the patients but instead talked about a range of other ‘very interesting’ subjects.

Bill’s interest in allergy grew and he pioneered major advances in the field, undertaking the first double-blinded controlled trial in immunotherapy, published in 1954. Bill was particularly proud of this study, especially when, in 2018, it was identified by the journal Allergy, as one of the four seminal papers in allergy of the 20^th Century. At the same time he pioneered the development and publication of the pollen count, such that it is now an integral part of weather forecasts during the spring and summer. His quest for understanding pathophysiology led him to self-experiment, inducing an almost fatal anaphylactic reaction in himself. Saved by a speedy injection of adrenaline, he described a feeling of ‘impending doom.’ Although he retired from St Mary’s in 1977, he continued to work as an honorary consultant at Guy’s Hospital for another 20 years,

Later Years

In later years he remained active, continuing to write and, where possible, lecture; his last lecture was given at St Mary’s in October 2017 to students on the MSc in Allergy. He gave multiple media appearances in recent years, ranging from Desert Island Discs to HardTalk, and in each he talked openly about his long and remarkable life. During these he also spoke quite vividly of his time as a prisoner of war, describing much of the suffering that he saw and endured. At the same time he worked tirelessly on his biography, From Hell Island to Hay Fever, The Life of Dr Bill Frankland. Bill remained mentally agile and insatiably curious up until the end of his life.  In January 2020 he was able to attend and contribute to an event exploring the medical aspects of captivity in the Far East. At the time of his 108^th birthday he gave an interview which included his perspective on the COVID-19 pandemic, and his own recollections of the influenza pandemic of 1918–20.

A Final Word

Bill Frankland was a most wonderful teacher who  inspired so many in the field. He was a prolific author, his first paper was published in 1941, his last in 2019. But above all he was a most generous doctor who gave so freely of his time and expertise to so many around the world. When asked, he told how he treated all patients the same ‘regardless of whether they were a prince or a pauper.’

Paul Watkins is the author of From Hell Island To Hay Fever - The Life of Dr Bill Frankland.

Prof Andrew Rice is Professor of Pain Research at the Department of Surgery and Cancer at Imperial College London