Just as I think everybody should have a living will, a plan for their funeral, and clear instructions on whether you want to be buried or cremated, so I advise thinking about your obituary or even obituaries. If you are a doctor you can be sure to get one in The BMJ so long as somebody writes one, but you might fancy trying for the newspapers. You might write it yourself, but many publications are sniffy about self-written obituaries. So you might do better to get somebody to write one for you, and that’s why Sir Anthony Grabham rang me.
Sir Anthony, who’s obituary you can read here, was a general surgeon, chairman of the council of the BMA, and the holder of many other posts. I knew him through the committee of the BMA that oversaw the BMJ Publishing Group, and for some 10 years he was chairman of the committee (and the board it changed into) while I was the editor of The BMJ and chief executive of the BMJ Publishing Group. We worked well together and liked each other, although we were very different: him being a polished master of the establishment, whereas I’m a “loose cannon,” to put it mildly.
We left The BMJ together more than 10 years ago, and I hadn’t seen Tony for probably eight years. So I was pleased, and, I must confess, flattered when he rang and asked me to write his obituary. Always proper, he had rung Fiona Godlee, the editor of The BMJ, to ask if it would be alright if he asked me. She said yes.
When he rang he told me that he had cancer and expected to be dead in four weeks. We chatted, caught up, reconnected, and laughed a lot. I said I would visit him to get his story. I went within days, frightened otherwise that I might not get to see him.
He looked very much his old self when I saw him, still handsome and well presented. He was, however, frail, and a nurse came to change his dressing during my visit. We talked for some two hours, with much pleasure on both sides. I started by asking him about what he saw as the climaxes of his career, great political battles of 40 years ago, from before I knew him. I greatly enjoyed his stories, and he enjoyed reliving them. Again there was much to laugh at. He told me things that he didn’t want included, usually because they could be damaging to people still living or the families of those dead. I respected all of his requests and never thought of not doing so, although I recognised that in some ways this compromised my “journalistic integrity” (an oxymoron to many).
Indeed, I was conscious that I was not operating as a journalist or historian pursuing the “truth” whatever the cost. I was being gently used. Tony (as I’ve always called him) didn’t ask me to show him what I wrote, but he had perhaps calculated that I would. I knew that I would and said so early on, perhaps even on our first phone call.
But we both knew that an obituary that was one triumph after another (sadly the standard BMJ obituary in my day) would be neither interesting nor credible. And, ironically, it’s easier to say negative things about the still living with their and their family’s consent than it is about the recently dead. If you read the obituary you’ll perhaps agree that there is more negative material than in the standard BMJ obituary, although the overall tone is very positive. For example, Tony described himself as a “middle of the road surgeon,” not a brilliant one, Barbara Castle, a secretary of state for health, thought him greedy and arrogant, and Henry Miller, a famous neurologist, said he was “useless” for failing to fully examine a patient.
I recorded our conversation, but I wrote the obituary from my notes and memory. I liked that I didn’t have to worry about length—because The BMJ will post obituaries of any length on thebmj.com. I emailed some old colleagues of Tony asking for stories that I told them would be unattributed. I also did a small amount of research, including reading William Osler’s essay Aequanimitas, Tony’s favourite reading. It provided useful insights.
I put together the obituary from this material, but mostly I used what he had told me. I posted it to him (he didn’t use email), saying he could make any changes, deletions, additions that he wanted. He rang me back quickly and had few changes but did have some additions. He disputed the factual accuracy of some of what others had told me, and so we took these out. Again there was much laughter and no tears.
Most obituaries are written from what others say rather than what the dead person has said, and perhaps this might seem like the difference between autobiographies, which are fiction in that we have all developed a story of our lives, and biographies, which in the best cases are deeply researched and objective in a way that autobiographies cannot be. But with obituaries there is no time for deep research, and the stories told by others may be just as fanciful, possibly more so, than the stories people tell about themselves.
Tony and I had interesting debates over whether he was ruthless and vain. Ruthless is a word often used about him, and he concedes that there was at least one time when he was undoubtedly ruthless. He wasn’t sure, however, that it was a personality trait. I said that I thought that being ruthless was not a bad thing. There are times when ruthlessness is needed, particularly by leaders like Tony, and it can be a fault not to possess it. It didn’t mean, I said, that you were ruthless every day, you were ruthless only when it was needed, which might be just once or twice in a lifetime. Tony was unconvinced, but it stayed in.
The idea of him being vain arose from a story about him that he insisted was untrue. As I had no other evidence of him being vain, I took it out, although he joked “I suppose the very fact that we are debating it may mean than I am vain.”
I got an editorial colleague who knew Tony well to prepare an 850 word version for the paper version of The BMJ. I shared that too with Tony, and we made some minor revisions. The BMJ’s press officer contacted the obituary editors of the Times, Daily Telegraph, and Independent. Tony was most keen to be in the Times because it was “his paper” and he dates from the days when The Times was undoubtedly the paper of the establishment. He wanted to be in the Daily Telegraph “because it’s the paper most doctors read,” and, although he described himself as “a bit of a leftie,” he didn’t care about the Guardian, perhaps because they wrote a critical editorial about a controversial speech he made.
The Times was willing to take a 1500 word version of the long BMJ obituary, and we found other old colleagues who were editors to write obituaries for the Daily Telegraph and Independent. One of them shared the piece with Tony, the other didn’t. I thought that a good thing as it would mean that at least one was written in the more usual way.
One anxiety was that with all these obituaries floating around one publication might make the mistake of publishing the obituary before Tony died. Luckily nobody did. I found the whole experience thoroughly enjoyable and I’m grateful to Tony for giving me the opportunity. I’m not, however, planning to make a career out of writing obituaries of the not yet dead, although I possibly could.
Competing interest. As the blog says, RS and Sir Anthony Grabham worked together for some 10 years and were fond of each other. RS was not paid for the obituary, and this blog was not shared with Grabham before he died, although it was shared with his family.
Richard Smith was the editor of The BMJ until 2004. He is now chair of the board of trustees of icddr,b [formerly International Centre for Diarrhoeal Disease Research, Bangladesh], and chair of the board of Patients Know Best. He is also a trustee of C3 Collaborating for Health.