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When I use a word, it means what I want it to mean—neither more nor less.” (Humpty Dumpty, Alice Through the Looking Glass. Lewis Carroll, 1872.)
So began a 1978 editorial published in the British Journal of Venereal Diseases, titled “Genito-urinary Medicine”. The death of its author on 19 September 2000 has deprived the specialty of one of its greatest champions.
John David Oriel was born in Devonport, England, in 1923. His father encouraged him to study law, but a childhood cycling accident resulting in a severe facial injury inclined him towards medicine. The accident also left him with a permanent scar which was the source of a slightly lop-sided impish grin that reflected the subtle dry sense of humour so characteristic of its owner.
Awarded a scholarship to the Leys School in Cambridge, David went on to study medicine at Guy's Hospital Medical School, London, qualifying MB, BS in 1947. He undertook his National Service and was with the RAF at Lyneham in Wiltshire, where he met and married his wife Joan, a state registered nurse. On discharge from military service, he worked as senior house officer at Putney Hospital, London, before entering general practice in nearby Streatham.
By the middle of the 1960s David was becoming restless with general practice, and began sessional work in venereology at St Thomas's Hospital, under the wing of Dr Claude Nicol. David's enthusiasm for the specialty was fired, and in particular an interest in genital warts. The commitment to venereology increased at the expense of general practice. In 1970, now aged 47, he successfully presented his thesis, for the degree of doctor of medicine, on the epidemiology and natural history of genital warts. David's ability to observe and record, coupled with the electron microscope skills of Dr June Almeida made this thesis a seminal study that has stood the test of time. General practice was finally abandoned in 1971, with his appointment as consultant physician (venereology) to Charing Cross Hospital, London. He moved to University College Hospital in 1972, to a run down department ripe for reincarnation. As was the case in most hospitals at that time, venereology was still in the dark ages of prejudice, with clinical premises consigned to a darkened basement at the back of the hospital. It was here in his smoke filled office that discussions took place in the early 1970s, leading to the classic studies on the epidemiology, laboratory diagnosis, and chemotherapy of chlamydial genital infection. Hours were spent discussing trial design and the results were fortified with coffee supplied by the indomitable Mrs Harvey against a background of disapproving clucks at the lack of oxygen. In time, David was able to influence both the hospital authorities and a wider net of the need to destigmatise “venereology”. At a local level this resulted in a complete refurbishment of the department, which now became brighter and less forbidding (but still in the basement). Strong links were forged with the microbiology department, such that staff from both departments overlapped in the “hot” laboratory, to the benefit of both. On a broader front, he was instrumental in changing the direction of the specialty away from consideration only of the classic venereal diseases to the wider spectrum of genitourinary medicine. This anticipated and prepared the specialty for the changing pattern of sexually transmitted infections, marked ultimately by the emergence of HIV infection.
Innovation was the hallmark of David's contribution to genitourinary medicine. A modest man, not open to self advertisement, many will be unaware of his major contributions to the management of sexually transmitted infections. These include the use of systemic antibiotics for chlamydial ophthalmia neonatorum and the routine addition of antichlamydial therapy to single dose therapy of gonorrhoea.
Working with David Oriel was always inspiring. However, he was a stern teacher, meticulous almost to obsession, and expecting high standards from his pupils. “Ridgway's fractured grammar” was an English language dialect that caused him much irritation. His published output was considerable, with some 90 peer reviewed publications during his 18 years of active service with genitourinary medicine. He also wrote a textbook on genital chlamydial infection, and edited (both jointly) the Proceedings of the 8th International Chlamydial Conference, held in Sanderstead, Surrey, in 1986. This was a particularly successful meeting, masterminded by David. Papers and books were supplemented by appearances in educational films.
In the United Kingdom, David was honoured by being elected president of the Medical Society for the Study of Venereal Diseases from 1985 to 1987. He was even more proud to be internationally recognised by receiving the Thomas Parran Award for Life Time Achievement by the American Venereal Disease Association in 1987. His many friends abroad will remember him as the epitome of an English gentleman.
After retirement in 1988, David turned his interest to the history of venereal disease. As well as yielding papers on the history of genital warts and non-gonococcal urethritis, and a series on eminent venereologists, this interest culminated in his book The Scars of Venus. Both title and text reflected his sense of humour and cutting prose. Even in retirement he still sought to educate, turning finally to diseases of the vulva. His contribution, Vulval Disease: A Practical Guide to Diagnosis and Management, one of two books jointly written with Drs C M Ridley and A J Robinson, was published recently.
Away from medicine David was a private person, often keeping his deepest thoughts to himself. A man with close family ties, his great loves were classical music, opera (with a penchant for Wagner), and jazz, literature, and politics. Time spent as a wartime evacuee in Pitlochry, Scotland, engendered a joy of hill walking.
Predeceased by Joan in 1998, David is survived by a daughter, two sons, and two grandchildren. None of his children has contemplated medicine. The mould is broken, but the achievements will remain with genitourinary medicine for ever.
David and I first met in the mid-1960s at St Thomas's Hospital when we were both training in venereology, as the specialty was then called. In addition to our clinical training we were engaged in research and we were both preparing MD theses at that time. These shared interests led to a friendship which continued throughout our subsequent careers. Although we never again worked in the same department, we frequently exchanged views and opinions. David was a ready source of wise advice, especially when it came to considering the merits of different consultant posts, a worry to trainee specialists then as now. As many colleagues have known, the wise advice in many fields continued.
David and I met in many places round the world. He was always an amusing companion who had original views on many topics. Sometimes conversations became too engrossing. I have a vivid memory of an incident some years ago; when filling in the time between the end of an overseas meeting and our flight home we were walking in a park. It was a lovely afternoon and we were discussing an interesting paper presented that morning. We were concentrating too much on our discussion and misjudged the flight of a powerful rotating hose; a sharp sprint ensued followed by a typical wry comment from David on how two senior consultants must have appeared to any onlooker who knew us. Life with David was always fun.
(Published simultaneously by Sexually Transmitted Diseases and Sexually Transmitted Infections. The photograph is taken from 75th Anniversary Supplement of Sexually Transmitted Infections 2000;76(Supp1).
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