A tribute to Professor Norman Morris
Professor Norman Morris, who died on 29th February, was an obstetrician responsible for re-evaluating and changing the care of women in pregnancy and in labour. He was the first clinical professor at Charing Cross hospital when he was appointed in 1958. The appointment was made on the basis of his academic interest and research into blood pressure in pregnancy and the function of the placenta. He continued this work at Charing Cross making significant contributions to the understanding of transport across the placenta in particular. The academic aspect of his career made a valuable contribution to the understanding of the physiology and pathology of pregnancy and labour. However, it is for promoting a humane and empathetic approach to patients that he will be chiefly remembered.
At the time of his appointment the medical approach to pregnant women was very paternalistic; a female obstetrician was a rarity. Norman Morris challenged the dualistic attitude of “I am the doctor. You are the patient”. He established his philosophy in a remarkable address on the inauguration of his chair at Charing Cross. This was published in The Lancet in 1960 as “Human relations in obstetric practice” and reprinted last year as one of the most influential papers of recent times. The only references were from women who had written of their unhappy experiences in pregnancy and birth. In the paper he wrote of the complacency of obstetricians. They had reduced maternal and infant mortality but had completely ignored the emotions. The joy that should accompany birth was lost in a “sea of inhumanity”.
He asked why this had happened. Why was no thought given to the mother as an individual? Where was sympathy and kindness? He urged his colleagues to change and to put their house in order. He emphasised the importance of talking and listening to patients. He was critical of the established division of pregnant and labouring women as “normal” and “abnormal”, pointing out that those classified as normal were then ignored as if on a production line. In all this he called for leadership from his fellow obstetricians and he himself led the way.
He re-planned his own unit to be as like the home as possible. He did away with the undignified and unnecessary enema and pubic shave that greeted all women on admission to the labour ward. He promoted antenatal classes as a time of preparation not only for labour but also for family life. Within these classes it was always made clear that he could not give women the perfect labour they wanted, but that he would do his utmost to ensure that he made the best of the labour they were going to have. Fathers were welcomed at the classes and in the delivery suite – an innovation that rapidly became standard practice.
He had the courage to criticise the standard of care at the time. He got the greatest response from women and women’s groups, from midwives and the younger generation. Gradually approaches changed spreading out from his department first at Charing Cross and later at the West London hospital. Labour wards were redesigned and attitudes of the professionals to pregnancy and labour changed to the lasting benefit of women.
He taught that the listening ear was the most important diagnostic tool in medicine, for physical diagnosis as well as to understand better the feelings of patients. He introduced weekly Balint-type groups under the supervision of a psychiatrist where difficult cases were discussed. Newcomers to the department soon found their stereotyped and conventional views gently demolished, but they were the better doctor for it.
Norman Frederick Morris was born on 26th February 1920 in Luton. Both parents had a social conscience which he inherited. He went to school in Dunstable and proceeded to St Mary’s medical school qualifying in 1943. It was here that he met one of the powerful influences on his professional life, Alec Bourne. Bourne had performed an abortion on a 14 year-old rape victim and had publicly given notice of his intention. Norman Morris greatly admired his courage in doing what he believed to be right regardless of opposition.
During the war he held several junior hospital doctor posts before joining the RAF as a surgical specialist. He then worked as a senior registrar in the department of obstetrics and gynaecology at Hammersmith Hospital. In 1956 he was appointed Reader in the academic department at University College Hospital under Professor Nixon, the other great influence in his humane approach. He was a founder of the International Society of Obstetrics and Gynaecology together with Lamaze, Vellay, Newton and Zigella. He founded BSPOGA, which he remained president of until his death.
He took on a prodigious amount of administrative responsibility. Within the University of London he was at various times Deputy Vice Chancellor, and Dean of the Faculty of Medicine. He was on the advisory forum to the Chief Medical Officer. He served as deputy chair of the N.W Thames regional health authority and was chair of the regional research committee. He was a visiting professor to 27 universities worldwide.
He remained active in his retirement being the director of postgraduate medical education at the Cromwell Hospital, and was always available for advice and counsel to those who asked. It was after a meeting at which he was trying to help resolve an ethical issue that he collapsed and died. He was blessed in his marriage of over 62 years to Lucy, who survives him, together with his four children who are all doctors.