It is with great sadness that we announce the death of Dr Nat Blau, who passed away on 26th June 2010 following a long battle with cancer. A co-founder of the Clinic, he worked tirelessly over the last 30 years and will be greatly missed by us all. Please join us in sharing our condolences with his wife, Jill and his children Justin, Adrian, and Rosie.
A full obituary is posted below and will be included in the next newsletter.
Joseph Norman Blau
Former consultant neurologist National Hospital for Neurology and Neurosurgery, London; Royal National Throat, Nose and Ear Hospital, London; Northwick Park Hospital and Medical Research Centre Harrow, Middlesex; honorary consultant neurologist and medical director, the City of London Migraine Clinic (b 1928; q St Bartholomew’s Hospital 1952; MD FRCP FRCPath), d 26 June 2010.
Born in Berlin on 5th October 1928 to Polish parents, Joseph Norman Blau (“Nat”) initially escaped the Nazis with a move to Poland in 1938. He was on the last boat to England before the invasion of Poland. On reaching London, he was evacuated to the country. His parents and sister were captured and shot by a Nazi firing squad in 1942. His determination and intelligence was apparent throughout his schooling and he secured a place at St Bartholomew’s Hospital medical school as an Open Science Scholar. After house jobs, he worked his National Service first as Lieutenant and then Captain in the Royal Army Medical Corps, including a year at Army Head Injuries Hospital. A Nuffield Medical Scholarship took him to Massachusetts General Hospital, Boston, where he undertook research on the thymus gland. Back in London, an MRC grant enabled him to continue research on Hassall’s corpuscles at Guy’s Hospital, gaining his MD while also working as a consultant neurologist at the National Hospital for Nervous Diseases.
In his clinical career, he trained in neurology as registrar, and later senior registrar to Lord Brain. During this time he met Dr Marcia Wilkinson with whom he shared a common personal affliction with migraine. In 1980, she invited Nat to join her in opening the City of London Migraine Clinic, a registered medical charity. He volunteered to work a day a week as a consultant neurologist at the clinic until ill health forced him to retire just six months before his death. A driving force behind the fundraising – an increasingly difficult task over recent times – he wrote personal letters to heads of City organisations highlighting disability from migraine and requesting donations to the charity. More often than not, he received a personal reply accompanied by a cheque.
His first paper on migraine was published in 1955. He went on to publish over 100 papers in scientific journals as well as numerous book chapters, a highly respected textbook on migraine and a book for the lay reader. He was a popular and eloquent speaker, with invitations from all parts of the globe. He talked to people, rather than at them, always requesting a tie microphone so that he could wander among the group and question unsuspecting members of the audience. No lecture was ever the same and all were remembered. He was active in the lay organisation Migraine Action (formerly the British Migraine Association), often talking at their AGM, and was their honorary medical advisor from 1980 to 2007. He served on Council of the neurological section of the Royal Society of Medicine and the Anglo-Dutch Migraine Association. Between 1994 and 1996 he was Chairman of the British Association for the Study of Headache.
He used his clinical acumen to further his research, focusing on the patient’s symptoms to help him to understand the pathophysiology. A popular quote of his was “Listen to the patient, he is telling you the diagnosis.” He would not be swayed by popular medical hypotheses. At a time when animal models for migraine were popular, he stood firm in his belief that we must look to the patient for the answers. The result was seminal papers on migraine precipitants, the phases of migraine attacks and behaviour during cluster headache. He also identified three new headaches. A deep thinker, he loved to discuss all aspects of migraine including historical and philosophical aspects. Faced with a comment or response with which he disagreed, he would raise his untamed eyebrows and a long pause would be followed by one of “Blau’s Laws” – all were peppered with humour but each held a profound truth. Favourites included: “Epidemiology is paralysis by analysis”; ”Better to have bad ideas than no ideas”; “Treat the man not the scan”; and “Decisive hesitation is better than hesitative decision.” He eschewed anything that could create a barrier between doctor and patient. This meant that the patient’s chair was placed beside the desk, years before this became the standard recommendation. Computers were equally seen as an unnecessary distraction during a consultation, although he embraced their use for his writing.
From an early age, he had been taught to consider Judaism to be a questioning religion. He believed that if you can question God, you can question anything. No research escaped critical review, resulting in stimulating debate. Also a writer, he spent many hours in the Royal Society of Medicine’s library and was a member of the Society of Authors. At home, he enjoyed smoking his pipe while he wrote. His other love was music, which he combined with medicine by playing the cello in the London Medical Orchestra and serving as honorary medical advisor to the British Association for Music Therapy.
He treated and improved the lives of thousands of patients suffering from migraine, cluster headache, and other debilitating headaches. He taught countless medical students and doctors, encouraging doctors training at the National Hospital of Neurology and Neurosurgery to sit in on his clinics. His questioning approach was polarising but all admired him for the thorough training that they received. Despite the significant impact he made in the field of headache, he was always modest and unassuming.
After a long battle with prostate cancer he is survived by his wife, Jill; three children; and four grandchildren.
Anne MacGregor
The City of London Migraine Clinic
