On Saturday morning, a sad Dr Sue Ruben phoned to let me know that our old friend and mentor Kevin White had died. He was 77 years old. Kevin retired from full time practice in 1993, but I have yet to come across anyone who could match his clinical skills. Contrary to popular opinion, there are plenty of good psychiatrists in the world, but Kevin was something different and rarer. He was a great clinician.
The accolades and prizes in medicine tend go to those who publish scientific papers and books; or who hold high office in professional organisations; or, in the worst cases, who indulge in self promotion. Kevin did none of these things. He worked for the whole of his career in central Liverpool, content to see patients and develop services. Although he never made a big thing of it, he had a strong affinity for the marginalised and the down-trodden. For example, he quietly developed drug dependency services in Liverpool. This work was unpopular and unrewarded, extra duties tagged onto his main job as a consultant general adult psychiatrist in a severely deprived part of the city.
Kevin did have some faults. He didn’t like writing things down. When I took over some of his patients on his retirement, the case notes were succinct to say the least. Instead, Kevin appeared to remember, in detail, every person he ever saw as a patient. I once asked him about someone who had come back from the USA after 15 years. Kevin had seen him twice as an outpatient before he left the country. When I mentioned his name, Kevin was able to give me full and accurate details about him, including the nature of his problems, the treatment plan and where he had lived at the time. For some years after he retired I could phone him about patients he had seen and he could always give me the information I needed. He had a comprehensive knowledge of the community he served, including who was related to whom. He acquired and retained this knowledge because he knew it mattered. He was a pioneering community psychiatrist who saw very early in his career that working with and within a community would work better for patients than institutional care ever could.
Kevin’s clinical skills were astonishing. In part, they rested on astute and careful observation. Some of it was about interpersonal skills. He had a way of getting people to tell him things. His interviews looked like ordinary conversations, but they weren’t. He had a casual, down-to-earth, Lancastrian manner and somehow he got people to make disclosures that they had never entrusted to anyone before.
I worked as a consultant alongside Kevin from 1988 until his retirement. I regularly asked his advice about difficult situations and without fail he would come up with something I hadn’t thought of. I had other colleagues who I respected, but I could predict what they’d say if I asked for advice. Not Kevin. I learnt a huge amount from him, and so did many other people.
If Kevin could comment on all of this, he would by now be grumbling. It always made him feel awkward to hear how highly he was regarded. I suspect that he didn’t really know what it was that made other clinicians think he was so special. I think the things that he did seemed obvious to him. This is a common feature of people who have advanced skills; it doesn’t feel difficult to them. Despite his reluctance, his importance was acknowledged in his lifetime. The drug dependency inpatient unit in Liverpool was, and is, named after him. When Robert Higgo and I wrote a book on psychiatric interviewing, we didn’t have to think very long about the dedication.
“This book is dedicated to Dr Kevin White. There may be better psychiatric interviewers in the world, but we’ve never met one.”
Apparently there was a copy of our book at his bedside when he died. That brought a tear to my eye.
Having said all of this, and setting aside my sense of loss, Kevin was not one of a kind. I have worked with several other great mental health professionals, but they haven’t been psychiatrists. Nor did Kevin belong to a lost golden age of psychiatry. There are certain to be other great psychiatrists out there right now. Their importance is that they inspire people and show them how this difficult art can be deployed to maximum effect. They demonstrate that the way that we do psychiatry is as important as what we do. In trying to emulate great but modest clinicians, those of us with lesser powers up our game. Kevin would have been delighted to know that this made him more like Dixie Dean than Sir Aubrey Lewis.