Norman Barrett
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Norman Rupert Barrett (16 May 1903 – 8 January 1979) was an Australian-born British
thoracic The thorax or chest is a part of the anatomy of humans, mammals, and other tetrapod animals located between the neck and the abdomen. In insects, crustaceans, and the extinct trilobites, the thorax is one of the three main divisions of the crea ...
surgeon who is widely yet mistakenly remembered for describing what became known as
Barrett's oesophagus Barrett's esophagus is a condition in which there is an abnormal (metaplastic) change in the mucosal cells lining the lower portion of the esophagus, from stratified squamous epithelium to simple columnar epithelium with interspersed goblet cell ...
.


Early life

Norman Barrett was born on 16 May 1903 in
Adelaide Adelaide ( ) is the capital city of South Australia, the state's largest city and the fifth-most populous city in Australia. "Adelaide" may refer to either Greater Adelaide (including the Adelaide Hills) or the Adelaide city centre. The dem ...
,
South Australia South Australia (commonly abbreviated as SA) is a state in the southern central part of Australia. It covers some of the most arid parts of the country. With a total land area of , it is the fourth-largest of Australia's states and territories ...
, to Alfred and Catherine Barrett. His great uncle, James Barrett, was a doctor, and four of James's children became doctors. One of these children, Norman's uncle Sir James Barrett, was a founder of the
Royal Australasian College of Surgeons The Royal Australasian College of Surgeons (RACS) is the leading advocate for surgical standards, professionalism and surgical education in Australia and New Zealand. Known by its common acronym RACS, it is a not-for-profit organisation, sup ...
and a
Chancellor Chancellor ( la, cancellarius) is a title of various official positions in the governments of many nations. The original chancellors were the of Roman courts of justice—ushers, who sat at the or lattice work screens of a basilica or law cou ...
of
Melbourne University The University of Melbourne is a public research university located in Melbourne, Australia. Founded in 1853, it is Australia's second oldest university and the oldest in Victoria. Its main campus is located in Parkville, an inner suburb nor ...
. Norman moved to
England England is a country that is part of the United Kingdom. It shares land borders with Wales to its west and Scotland to its north. The Irish Sea lies northwest and the Celtic Sea to the southwest. It is separated from continental Europe b ...
at the age of 10, and was educated at
The New Beacon , motto_translation = Give light out of darkness , established = , closed = , type = Preparatory School , religious_affiliation = , president = , head_label = Headmas ...
,
Eton College Eton College () is a public school in Eton, Berkshire, England. It was founded in 1440 by Henry VI under the name ''Kynge's College of Our Ladye of Eton besyde Windesore'',Nevill, p. 3 ff. intended as a sister institution to King's College, C ...
and
Trinity College Trinity College may refer to: Australia * Trinity Anglican College, an Anglican coeducational primary and secondary school in , New South Wales * Trinity Catholic College, Auburn, a coeducational school in the inner-western suburbs of Sydney, New ...
,
Cambridge Cambridge ( ) is a university city and the county town in Cambridgeshire, England. It is located on the River Cam approximately north of London. As of the 2021 United Kingdom census, the population of Cambridge was 145,700. Cambridge bec ...
. He was given his lifelong nickname, Pasty, while at Eton.


Career

He trained at
St. Thomas' Hospital St Thomas' Hospital is a large NHS teaching hospital in Central London, England. It is one of the institutions that compose the King's Health Partners, an academic health science centre. Administratively part of the Guy's and St Thomas' NHS Foun ...
, and graduated in 1928. He continued as resident assistant surgeon at St. Thomas' Hospital, and was elected as
Fellow of the Royal College of Surgeons Fellowship of the Royal Colleges of Surgeons (FRCS) is a professional qualification to practise as a senior surgeon in Ireland or the United Kingdom. It is bestowed on an intercollegiate basis by the four Royal Colleges of Surgeons (the Royal C ...
in 1930. He was awarded the postgraduate degree M Chir in 1931. In 1935, he became a
Consultant Surgeon In the United Kingdom, Ireland, and parts of the Commonwealth, consultant is the title of a senior hospital-based physician or surgeon who has completed all of their specialist training and been placed on the specialist register in their chosen ...
at St. Thomas', where he remained for the rest of his career. He travelled to the United States on a Rockefeller Travelling Fellowship from 1935 to 1936, working at the
Mayo Clinic The Mayo Clinic () is a nonprofit American academic medical center focused on integrated health care, education, and research. It employs over 4,500 physicians and scientists, along with another 58,400 administrative and allied health staff, ...
, and visiting
Boston Boston (), officially the City of Boston, is the state capital and most populous city of the Commonwealth of Massachusetts, as well as the cultural and financial center of the New England region of the United States. It is the 24th- mo ...
,
St. Louis St. Louis () is the second-largest city in Missouri, United States. It sits near the confluence of the Mississippi and the Missouri Rivers. In 2020, the city proper had a population of 301,578, while the bi-state metropolitan area, which e ...
and
Michigan Michigan () is a state in the Great Lakes region of the upper Midwestern United States. With a population of nearly 10.12 million and an area of nearly , Michigan is the 10th-largest state by population, the 11th-largest by area, and the ...
. It was during this time that he decided to focus on
thoracic surgery Cardiothoracic surgery is the field of medicine involved in surgical treatment of organs inside the thoracic cavity — generally treatment of conditions of the heart (heart disease), lungs (lung disease), and other pleural or mediastinal struc ...
, rather than gastrointestinal surgery as he had initially intended. In 1946, he wrote a paper for the first issue of ''Thorax'' on spontaneous rupture of the
oesophagus The esophagus (American English) or oesophagus (British English; both ), non-technically known also as the food pipe or gullet, is an organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to the ...
(
Boerhaave syndrome Esophageal rupture is a rupture of the esophageal wall. Iatrogenic causes account for approximately 56% of esophageal perforations, usually due to medical instrumentation such as an endoscopy or paraesophageal surgery. In contrast, the term Boerh ...
), in which he commented that "in the byways of surgery there can be few conditions more dramatic in their presentation and more terrible in their symptoms than spontaneous perforation of the oesophagus. No case has yet been treated successfully, and diagnosis has only been achieved in a very few before death." A year later, on 7 March 1947, he performed the first successful repair of a ruptured oesophagus. In 1950, he published a paper in which he described the oesophagus as "that part of the
foregut The foregut is the anterior part of the alimentary canal, from the mouth to the duodenum at the entrance of the bile duct. Beyond the stomach, the foregut is attached to the abdominal walls by mesentery. The foregut arises from the endoderm, deve ...
,
distal Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pro ...
to the cricopharyngeal sphincter, which is lined by
squamous epithelium Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellula ...
." In this paper, Barrett suggested that the finding of an oesophagus lined with
columnar epithelium Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellular ...
(rather than the usual squamous epithelium) was due to the presence of a congenitally shortened oesophagus leading to a tubular portion of stomach being trapped in the chest. In this article Barrett credited Philip Rowland Allison for coining the term
reflux oesophagitis Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is one of the upper gastrointestinal chronic diseases where stomach content persistently and regularly flows up into the esophagus, resulting in symptoms and/ ...
in 1948, noting that was the 'best name for the lesion' Allison had so ably described. In contrast, Philip Rowland Allison and
Alan Johnstone Sir Alan Vanden-Bempde-Johnstone (31 August 1858 – 31 July 1932) was a British diplomat. Biography Johnstone was a younger son of Harcourt Vanden-Bempde-Johnstone, 1st Baron Derwent, and Charlotte Mills. He entered Her Majesty's Diplomat ...
argued that this
columnar epithelium Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellular ...
–lined structure was oesophagus and not stomach, and suggested that
ulcer An ulcer is a discontinuity or break in a bodily membrane that impedes normal function of the affected organ. According to Robbins's pathology, "ulcer is the breach of the continuity of skin, epithelium or mucous membrane caused by sloughing o ...
s in this structure be called "Barrett's ulcers". Seven years after his initial article Barrett accepted this view, suggesting that it be called the "lower oesophagus lined by columnar epithelium". The columnar epithelium ascending the esophagus from the stomach has subsequently become known as Barrett's oesophagus. In addition to his work on oesophageal disease, Barrett also worked with Leonard Dudgeon, Professor of
Pathology Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in ...
at the
University of London The University of London (UoL; abbreviated as Lond or more rarely Londin in post-nominals) is a federal public research university located in London, England, United Kingdom. The university was established by royal charter in 1836 as a degree ...
, on the
cytology Cell biology (also cellular biology or cytology) is a branch of biology that studies the structure, function, and behavior of cells. All living organisms are made of cells. A cell is the basic unit of life that is responsible for the living and ...
of
sputum Sputum is mucus that is coughed up from the lower airways (the trachea and bronchi). In medicine, sputum samples are usually used for a naked eye examination, microbiological investigation of respiratory infections and cytological investigations ...
in the diagnosis of pulmonary malignancy. He is also noted for his treatment of hydatid cysts. Barrett was a lecturer in surgery for the
University of London The University of London (UoL; abbreviated as Lond or more rarely Londin in post-nominals) is a federal public research university located in London, England, United Kingdom. The university was established by royal charter in 1836 as a degree ...
(1935–1970), Surgeon to
King Edward VII Edward VII (Albert Edward; 9 November 1841 – 6 May 1910) was King of the United Kingdom of Great Britain and Ireland and Emperor of India, from 22 January 1901 until his death in 1910. The second child and eldest son of Queen Victoria a ...
Sanatorium A sanatorium (from Latin '' sānāre'' 'to heal, make healthy'), also sanitarium or sanitorium, are antiquated names for specialised hospitals, for the treatment of specific diseases, related ailments and convalescence. Sanatoriums are often ...
in
Midhurst Midhurst () is a market town, parish and civil parish in West Sussex, England. It lies on the River Rother inland from the English Channel, and north of the county town of Chichester. The name Midhurst was first recorded in 1186 as ''Middeh ...
, Sussex (1938–1970), and Consulting Thoracic Surgeon to both the
Royal Navy The Royal Navy (RN) is the United Kingdom's naval warfare force. Although warships were used by English and Scottish kings from the early medieval period, the first major maritime engagements were fought in the Hundred Years' War against F ...
and the
Ministry of Social Security Ministry of Social Security or Department of Social Security is the government entity responsible for social security affairs. It may be a ministry office, a department, or, as in the United States, a nominally independent agency. Notable ones ar ...
(1944–1970).AIM25 archive of Norman Barrett
/ref> He edited ''
Thorax The thorax or chest is a part of the anatomy of humans, mammals, and other tetrapod animals located between the neck and the abdomen. In insects, crustaceans, and the extinct trilobites, the thorax is one of the three main divisions of the cre ...
'', the journal of thoracic surgery, from its inception in 1946 until 1971.


Personal life

Norman Barrett married Annabel Elizabeth "Betty" Warington Smyth on 21 April 1931. She was the sister of a school friend, and they had met six years previously. Betty had studied English and Art, and later became a novelist. They had two children, Julia and Althea. After Norman had been appointed a Consultant at St. Thomas' Hospital, the Barrett family lived at 2 Dorset Street,
Marylebone Marylebone (usually , also , ) is a district in the West End of London, in the City of Westminster. Oxford Street, Europe's busiest shopping street, forms its southern boundary. An Civil parish#Ancient parishes, ancient parish and latterly a ...
,
London London is the capital and largest city of England and the United Kingdom, with a population of just under 9 million. It stands on the River Thames in south-east England at the head of a estuary down to the North Sea, and has been a majo ...
for about 20 years. In 1954 they moved to
Richmond Green Richmond Green is a recreation area near the centre of Richmond, a town of about 20,000 inhabitants situated in south-west London. Owned by the Crown Estate, it is leased to the London Borough of Richmond upon Thames. The Green, which has been ...
. Outside his medical interests, he was also interested in the
history of medicine The history of medicine is both a study of medicine throughout history as well as a multidisciplinary field of study that seeks to explore and understand medical practices, both past and present, throughout human societies. More than just histo ...
, drawing and painting, and was a keen sailor. He was appointed a
CBE The Most Excellent Order of the British Empire is a British order of chivalry, rewarding contributions to the arts and sciences, work with charitable and welfare organisations, and public service outside the civil service. It was established o ...
in 1969, and retired in 1970. He died in London on 8 January 1979.


References

{{DEFAULTSORT:Barrett, Norman British thoracic surgeons People educated at Eton College Alumni of Trinity College, Cambridge 1903 births 1979 deaths 20th-century British medical doctors 20th-century surgeons Australian emigrants to the United Kingdom