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Emeritus Professor Ian Logan Craft FRCS FRCOG: a ‘Universal Genius’ with scientific and artistic qualities

2019; Elsevier BV; Volume: 39; Issue: 4 Linguagem: Inglês

10.1016/j.rbmo.2019.07.036

1472-6491

John L. Yovich, Joyce Harper,

Healthcare Systems and Challenges

We are saddened at the passing of our colleague and friend ‘Prof’ Ian Craft on 3 June 2019 at his residential home at Esher in Surrey, England. It was a peaceful departure as his normally super-abundant energy simply faded away over his last few days. Both I (JLY, who worked with Ian from 1976 to 1980, maintaining a friendship thereafter) and Joyce (JCH, who worked with Prof as scientific director from 1988 to 1992 and remained a close friend in his retirement) would like to indicate that Ian was the modern-day ‘Universal Genius’. This term, applied to Leonardo Da Vinci who died exactly 500 years ago, relates to a person of ‘unquenchable curiosity’ and defines our man precisely. Neither JCH nor I can identify any other person in our combined life experiences who can be similarly defined. We express the view that it is a great sadness that such a facility is limited by the human lifespan; and also places the person ‘out-of-step’ with his contemporaries. This might explain why the press portrayed a position of conflict between Ian and Dame Mary Donaldson who (in response to a newspaper reporter’s questions in 1993 about donor eggs, embryo numbers for transfer and age-limits) made the sharp comment ‘Everyone was working very hard to do a good job and you have one man out of step who is prejudicing the whole issue – although he insists everyone else is out of step.’ (The UK’s Human Fertilisation and Embryology Authority had been established 3 years previously under legislation initiated by Baroness Warnock). We believe Dame Mary did not appreciate the Universal Genius who was indeed ‘stepping in advance’ of others and, having exceptional analytical skills, as well as enormous zeal and energy, kept moving ahead, not waiting for others to ‘catch up’. British-born Ian Logan Craft had trained in several London National Health Service (NHS) hospitals and gained fellowship of the Royal College of Surgeons (FRCS) at an early stage. He published his first article (on ankle joint injury) in The Lancet in 1964 during his rotation as an orthopaedic resident. Thereafter several articles were published in the British Medical Journal in 1967 when we was house surgeon in the Department of Surgery at Hammersmith Hospital, relating to duodenal diverticula causing various complications. He then moved to Westminster Hospital, gaining an interest in obstetrics and gynaecology, thereafter rotating to Kingston Hospital in Surrey where he published a number of articles covering physiology, biochemistry and procedures in both general surgery and obstetrics and gynaecology over the years 1969–1971. Remaining at Kingston, Ian developed a major interest in the use of prostaglandins for initiation of labour and pregnancy termination. He also focused on contraception and sterilization procedures along with associated ethical issues for both males and females; publishing extensively over the years 1972–1976, including a large series of vasectomies. His next position was at Queen Charlotte’s Hospital where Ian’s interests expanded to include hysteroscopy and laparoscopy techniques, particularly trialling a range of tubal clips and intratubal stents for sterilization, again often presenting his findings at Royal Society of Medicine meetings and publishing contributions widely in journals and books during the years 1976–1979. Clearly Ian had exceptional insight into every area of medicine to which he was exposed and dwelt on understanding the aetiology of conditions before moving the therapeutic approaches in new directions. In 1976, at age 39 years – as the ‘youngest, but brightest candidate for the position’ according to the Royal College of Obstetrics and Gynecology’s giant Sir Jack Dewhurst – Ian was appointed Professor of Obstetrics and Gynaecology at the Royal Free Hospital (RFH) situated in Hampstead. On the very day Ian walked into his office on the fifth floor he was joined by JLY (newly arrived from Australia), and we worked closely together across the period 1976–1980. At the RFH Ian conducted ground-breaking work which resulted in the birth of Europe’s first IVF twins in April 1982. An earlier, well documented IVF pregnancy miscarried at 9 weeks in 1979. In August 1982 Ian also published the birth of infants arising from the transfer of gametes (eggs and sperm) to the uterus. His team subsequently reported the birth of UK’s first IVF triplets in 1984. He was a ‘frontiersman’ in this new world of modern obstetrics that embraced ultrasound technology, advanced hormone assays, minimally invasive gynaecology and reproduction by IVF-related procedures. He thereafter had many other ‘firsts’ including live births after pronuclear-stage transfers to the uterus (1985); developing the Craft oocyte aspiration pump with colleagues at Rocket Engineering (1984); introducing GnRH analogues into the ovarian stimulation schedule (1984); reporting the first live births in the UK from the gamete intrafallopian transfer (GIFT) procedure (1986) and other tubal transfer procedures (1988–1991). In 1987, Ian reported Europe’s first donor-egg birth and he was granted the first UK licence to do intracytoplasmic sperm injection (ICSI), reporting the UK’s first ICSI birth in 1994. He also reported successful pregnancy outcomes from the percutaneous epididymal sperm aspiration (PESA) procedure undertaken on vasectomised males (1995). His rapid adoption of new ideas placed Ian at the forefront of both developments as well as contentious issues and led him to establishing private IVF clinics, firstly at the Cromwell Hospital (3 years), then the Humana Wellington Hospital in St John’s Wood overlooking Lord’s cricket ground (5 years). He was joined by embryologist JCH in 1988 who also helped Ian to design the advanced and beautiful London Gynaecology and Fertility Centre in Cozens House at 112A Harley Street (fronting Devonshire Place) into which they moved in 1990 and where JLY also worked intermittently during the 1990s. At this time, the Craft team also established the first IVF unit in Dubai. All this rapid ‘frontiersman’ activity saw Ian become a target for controversial articles in the press. These related to treating older women, utilising donor oocytes, and introducing surrogacy prior to these processes becoming standard practice. The issue of transferring more than three embryos in older women was also played out in public as expressed above. Ian sold his Harley Street Clinic in 2009, aged 72 years and faced the next few years dealing with prostate-related health issues. He lost contact with friends for a period, re-emerging in 2017 once he gained control over his medical complications. Over his professional lifetime he helped thousands of couples achieve a family and was responsible for the delivery of thousands of newborns, many of which were delivered personally by Ian (and JLY) applying the principles of active management of labour and conducting our own epidurals through to the late 1990s. In fact, this created further controversy for Ian who faced a movement in the 1970s led by ‘colourful’ London psychiatrist Rodney Laing. The movement comprised mainly women from the highest socio-economic class who were opposed to the ‘institutionalisation of childbirth practices in Western society’, described by Laing in the documentary Birth in 1978. On two occasions at the RFH Ian’s Citroen 2CV was painted pink or tipped over; but Ian was unfazed. He was a man who was totally dedicated to the obstetric and fertility fields, who worked incessantly ‘24/7 × 52 weeks’, apart from one brief holiday to Australia. It was this obsession that caused his wonderful and supportive wife Jackie (they married as teenagers) to separate from him late in life so that each could pursue their own path. Ian continued to push back the boundaries and remained a true medical innovator until retirement. PubMed lists 266 publications under his name, but many scientists and clinicians working in IVF would feel this under-represents Ian’s contribution. He presented widely and frequently; his intelligence and charm made him one of the most renowned IVF experts, a large proportion of whom carry his legacy. In fact, it was Ian’s magnetic charm that enabled him to develop his IVF programme within the NHS, receiving a substantial donation from Roger Waters of Pink Floyd fame when Ian managed the pregnancy of Waters’ second wife Lady Caroline Christie during 1977 and delivered their daughter, India, in January 1978. Ian was born on 11 July 1937 in Wanstead, UK. He was a twin, but his twin sister died at birth. He leaves two younger brothers, popular racing car driver at Brand’s Hatch, Christopher, and Andrew (whom Ian described fondly ‘should have been a professional comedian’), as well as ex-wife Jackie, two sons and two grandchildren. Ian’s uncle – his father’s brother Stanley Edwin Craft (1891–1969) – migrated to Australia in 1905 and became well known in Perth as the organist at Wesley Church and played both piano and organ in the West Australian Symphony Orchestra. Much is written about Stanley, also regarded as an innovator in musical teaching and practice. Stanley’s son Colin Craft, a champion swimmer, became a war hero with the highly revered Z Force, blowing up Japanese destroyers with hand-placed limpet mines during the Second World War invasion of Singapore. Colin was eventually captured aged 25 years and decapitated by sword – a swift process that the Japanese reserved for enemy heroes. A second son, Warren, established a wheat and sheep farm in Trayning, 236 km east of Perth, which Ian visited in 1979 during his brief holiday in Australia (while JLY ‘held the fort’ at the RFH in London). Both JLY and JCH recall Ian’s intense interest in theatre and music and his attendance at numerous events in London’s West End and other locations in and around the capital. Ian stated ‘It is of interest that my father and grandfather played both the piano and organ which they had learnt at home as youngsters in London. Sadly, I was not put to music but I have made up for this by commissioning two compositions (Robert Simpson’s 6th Symphony and Sir Peter Maxwell Davies’ Clarinet Concerto in memory of my father) but sadly only one is on CD. They were first played in Lucerne and next at The Cheltenham Festival and I went to both.’ Ian’s devotion to the arts was expressed in his renaissance with a renewed passion for the opera, musical concerts and the ballet. He also discovered a new-found enthusiasm for the cinema, becoming a member of the Everyman Cinema in Esher. He pursued these areas with his former zeal and intense focus once he recovered from his illness. In particular he seemed to have resumed his former high energy levels in the latter 2 to 3 years of his life, when he focussed on his greatest love, enjoying his collection of artistic works, including impressive statues, acquired over his busy lifetime. A memorial to celebrate the life of Professor Ian Craft will be held on Thursday 19th September at St James’s Church, Piccadilly at noon.