On the Shoulders of Giants: A tribute to David Goldberg

Professor Sir David Goldberg (1934 – 2024)

Tomorrow, 4th of June, the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, together with the Psychiatry Research Trust, are hosting a commemorative event to celebrate the life and work of Professor Sir David Goldberg.

When I started training in psychiatry in 1981, apart from the six months in academic psychiatry, all my training was in asylums in Leicestershire. Working in clinical settings and reviewing research, I came across the General Health Questionnaire (GHQ) and the name David Goldberg as its creator.

Along with all trainees and colleagues, I was aware of his name, reputation, and status. We would discuss his papers in the journal club and were in awe of him and his contribution to psychiatric research.

After finishing my basic training, I joined the Maudsley (as there was no SLaM at that time) rotational higher training scheme. My first-year posting was at Hellingly Hospital, Hailsham, near Eastbourne. The following year, I was posted to the Bethlem Royal Hospital, working with four consultants. Now, as a retired Professor of Psychiatry at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London (IoPPN), where David eventually came to work until his retirement in 2000, and in preparation for an event that will commemorate David’s legacy next week organised by IoPPN and the Psychiatry Research Trust, I find myself reflecting on those early years and the impact that David has had on me, both personally and professionally. 

My first face-to-face contact with David was in that position. As Chair of the Joint Committee for Higher Training (JCHPT) of the Royal College of Psychiatrists, he led the college inspection of higher training at Bethlem-Maudsley, including various outposts. Those were the days when the College conducted site visits to ensure standards of training, supervision, and academic learning. David was very matter-of-fact and said that there was no way I should be working with four consultants. A couple of years later, out of the blue, I got a phone call from him offering me a job in Manchester, which I very politely declined. On the phone call, it was, again, a very matter-of-fact and focused conversation. Another couple of years later, he arrived at the Institute of Psychiatry (IOP as it was called at the time) as Head of the Department, replacing Professor Gerald Russell, who had retired, and I had the pleasure and honour of working for him as Senior Lecturer.

David Paul Brandes Goldberg was born in January 1934 in London. He was just 5 years old when the Second World War broke out, and for a period, his family moved to Oxfordshire near Banbury. As a newbie, local children ganged up on David, and he mentions in his privately published memoirs that he started "making exploding jam jars with calcium carbide and a little water to keep our enemies in order and maybe treat us with greater respect!" It is not clear in this feeling whether these enemies were bullies at school or the Germans. David's father was a civil servant and was sent to the USA in order to negotiate a contract between the two governments. He told the family that were Nazis to invade Britain, he would kill them. David mentioned that he kept the bottle of barbitone (a powerful sedative) in his desk to remind him of those peculiar days.

When I had the privilege of interviewing him for my book, Psychiatrists on Psychiatry, he talked about not being able to understand why people he had never met were determined to kill him. He was getting ready to leave for the USA, and the ship that left before his was supposed to was torpedoed, killing all the children on board, and as a result, his parents changed their minds and David stayed on in the UK. 

In 1952, he went to Oxford to study medicine. He was interested in doing psychology, but had to be re-examined in Latin. His father had run rehabilitation units for returning soldiers, which really interested David. He studied medicine and then moved to St Thomas’ Hospital in London, where he came across a paper, Between doubts and certainty in psychiatry, by Sir Aubrey Lewis, who was based at the Institute of Psychiatry and the Maudsley Hospital. David noted in his life story that Sir Aubrey Lewis (Head at the Institute of Psychiatry) had a different perspective on psychiatric disorders, unlike William Sargent (based at St Thomas’ Hospital), who saw mental illnesses as just like physical illnesses. David took his MRCP examination multiple times and kept failing. Perhaps that is why he took on a rebellious position against the establishment of the Royal College of Psychiatrists when it was being set up in 1971. He felt that the new College would do exactly what the old colleges were doing—examinations would become expensive, and the College would use this as a money-making activity. Consequently, the College decided never to make any profits from exams and invest the profits in the examinations themselves.

He arrived in the Maudsley for training in psychiatry, and six out of ten of his cohort went on to become professors. While training at the Maudsley, David got interested in the General Practice Research Unit run by Professor Michael Shephard, and he developed the General Health Questionnaire and Clinical Interview Schedule. He then went to Philadelphia to obtain what he called a BTA (Been to America) degree. He worked in the Community Mental Health Centre initially and then at the University of Pennsylvania. He returned to Manchester, where he continued to work in primary care psychiatry. He changed the training model using videos to train junior doctors. When he set up a Master's course for International Medical Graduates. He worked with his NHS colleagues and banks to help new arrivals settle down. His research remained focused on general practice, and subsequently, he spent a sabbatical year in South Carolina, where he said that he learnt to use recordings to help improve general practitioners' skills in mental health care. In Manchester with Peter Huxley, he developed the pyramid model of mental healthcare and led research in pathways to care. Upon his return, he continued to improve teaching and training. He continued to innovate research as well as clinical practice.

Sir David received a knighthood in 1997 for his contributions to medicine

David returned to the Institute of Psychiatry in 1993 for seven years before retirement. He established interdisciplinary research groups, set up Maudsley debates and discussion papers, and revived Maudsley monographs, amongst other innovations. Bethlem celebrated its 750th anniversary during his time, and he worked with the King’s Fund to celebrate it and commissioned Professor Roy Porter to write a book on the history of Bethlem. His style was facilitatory. When I joined him and his department in 1994, I recall him popping into my office before a meeting where he was chairing, and I was attending. He asked me about participants, their strengths and likely challenges, and what the outcomes we wanted were.

When I requested him to look at my PhD thesis, not only did he agree very promptly, but within 48 hours, he had commented on it in detail with some irate comments. Ilfra, his wife, rang me to ask me not to mind as he was in bed and had a horrible cold and was being grumpy. He met Ilfra while they both were at St Thomas Hospital and got married in 1966 and had four children, Paul, Charlotte, Kate and Emma, with grandchildren. David was a handyman as well and did electrical wiring himself in various houses they lived in.

David with his wife, Ilfra

He met Anne during his Oxford days, and their relationship at that time lasted two years. Subsequently, she moved to New York and in his later years returned to London to be with him for 3-4 years as Ilfra had predeceased David.

After retirement, David took on the role of Chair of Psychiatry Research Trust—a mental health charity that is now a partner of ITM in supporting writers with lived experience. He continued with lectures and worked with the World Health Organization (WHO) on various surveys in primary care and helping develop diagnostic classification of psychiatric disorders in primary care.

David on his 90th birthday, with Dinesh and with Gabby Ivbijaro, a GP whom David supervised for his PhD

After he developed dementia, my partner and I would go to his place almost every week and spend an hour or so with a bottle of bubbly. He remained interested, enjoying our visits and talks, and we would share jokes and old stories. His sense of humour would emerge from time to time, reminding us of his vivacity and energy. He described himself as an average academic and was really proud of his family.

Please join us at the IoPPN on the 4th of June to celebrate David!