Gentleman Jim: neurologist, mentor and inspiration

JIM MCLEOD, 1932-2022

Jim McLeod was a world authority in the fields of multiple sclerosis and disorders of peripheral nerves. He was the Foundation Bushell professor of neurology at the University of Sydney and the first established chair of neurology in Australia, a position he held until his retirement. He served as a head of the neurology department at RPAH and head of the department of medicine at the university. McLeod was a leading figure in Australian neurology and, along with his good friend Jim Lance, established world-class neurological centres in Sydney.

James Graham McLeod was born on 18 January 1932, the son, and grandson, of builders. During WWI his father, Hector, fought in France and his mother, Dorothy (nee Craig), trained as a nurse to support the war effort.

Professor Jim McLeod was a leading figure in Australian neurology.

After the war, his parents moved to Ashfield, where McLeod was born, the youngest of four children by several years. He was an exceptional student and dux of his leaving year at Sydney Grammar School. His early ambition was to become a veterinarian, because of his love of animals, but instead, but he followed his father’s advice to accept a scholarship to study medicine at the University of Sydney, and never looked back.

McLeod’s involvement with the University of Sydney, both professionally and spiritually, was lifelong. He is an alumnus of the University’s St Paul’s College, where he was a sub-warden (1958). While completing a BSc (Med) in 1953, McLeod met Professor Frank Cotton, who was assessing students for their physical capacity for rowing. Although McLeod had no experience in this sport, results of his tests suggested he may succeed as an oarsman. Indeed, he won a university Blue in rowing (also in rifle shooting) and represented NSW in the King’s Cup.

McLeod was awarded a Rhodes Scholarship to Oxford University in 1953, and in 1956 graduated DPhil (Oxon) for his studies into the physiology of pain. During his candidature he represented Oxford in the Oxford and Cambridge boat race and in 1954, with three other Australia scholars in the crew, helped Oxford to win the centenary race.

Perhaps it was juggling the demands of both intense rowing training and research that led to his incredible life-long work ethic. McLeod was a hard worker, and recalled being so immersed in research that he missed watching his friend Roger Bannister break the four-minute mile nearby.

McLeod proved an exceptional sportsman at Oxford, but it was his intellectual life that ultimately consumed and defined him. He returned to Australia and completed his medical studies and clinical training at Royal Prince Alfred Hospital, where he was appointed clinical superintendent in 1963. There he met Robyn Rule, a nurse, and they married in Sydney University’s St Paul’s College Chapel. His family returned there to commemorate his life.

McLeod studied and worked abroad for periods throughout his career. He was awarded two travelling fellowships, and studied at the Institute of Neurology at the National Hospital, Queen Square, London in 1964 and at Harvard University in 1965. He returned to Sydney University, where, in 1967, he was appointed senior lecturer in medicine, and then associate professor three years later.

In the years that followed, McLeod worked feverishly; there was never an unproductive hour. He didn’t stop for lunch, getting through the day on an apple combined with a constant flow of instant coffee. He said he didn’t have time for lunch – and that food drained the blood from the brain to the stomach, and would therefore make the afternoon less productive. He would likewise work long into the evening in his home office, writing, dictating and marking.

McLeod’s international legacy in neurology is immense. In the late 1960s and early ’70s he established, with John Walsh, the first department of clinical neurophysiology in Australia at RPAH. They developed new techniques that allowed the definitive diagnosis of common neuropathies, and neurologists and other physicians visited from around Australia and New Zealand to learn them. McLeod examined many patients with inherited neuropathies and constructed and collected careful family histories. Using this data, Garth Nicholson, one of McLeod’s proteges, achieved a world first in defining the gene abnormality responsible for the commonest genetic neuropathy.

McLeod was among the first researchers internationally to define a group of severely disabling neuropathies, which were shown to have an autoimmune basis (chronic inflammatory demyelinating polyneuropathy – CIDP). With professors John Prineas, Pam McCombe and John Pollard, he studied their pathology and detailed clinical, neurophysiological and immunogenic features.

He encouraged research into new immune therapies and his team collaborated with the departments of haematology and immunology at RPAH, introducing plasmapheresis and intravenous immunoglobulin for the first time in Australia, which helped many patients who would otherwise have been confined to wheelchairs.

When McLeod was appointed head of the neurology department at RPAH, he established specialised units in stroke, neuropsychology, hearing and balance, molecular neurology, comprehensive epilepsy service, neuromuscular and others. This was a bold plan, and he achieved it with distinction. Several of these units are renowned internationally.

McLeod began to focus his interest on the commonest neurological autoimmune disease, multiple sclerosis (MS), making major contributions to its epidemiology and treatment. With Professor Basten, he performed the first clinical trials of immunotherapy for MS in Australia, firstly with transfer factor and then with beta interferon. Subsequent international controlled trials of immunotherapies, building on this work, have changed the course of multiple sclerosis for many people.

In 1993, with the MS Society of NSW, McLeod established a weekly clinic for the assessment and management of patients with suspected MS, providing physiotherapy and other ancillary services, and open to all patients throughout NSW at no cost. This clinic continues and is attended by many people from country centres where specialist medical services are more difficult to obtain.

In addition to his demanding work at the coalface of research, McLeod laboured to develop the necessary infrastructure to support the research and the patients affected by MS. He was actively involved with the Multiple Sclerosis Society of Australia over 20 years, as member of the research advisory board, including as chairman and vice-chairman. He was a member of the international advisory board of the International Federation of MS societies. With colleagues at the university, he established the Nerve Research Foundation to support research into MS and other neurological diseases.

In 1981 McLeod was elected fellow of the Australian Academy of Science and was a member of council, vice-president and treasurer. He was also elected fellow of the Australian Academy of Technological Sciences and Engineering in 1987. In 1986, he was made an Officer in the Order of Australia for services to medicine, particularly in the field of neurology, and in 2001 was awarded the Centenary Medal for services to Australian society and science in clinical neuroscience.

In 1990, McLeod was appointed chairman of the Institute of Neuroscience at RPAH, and in 1995, director of neuroscience for the Central Sydney Area Health Service. He later became the president of the Australian Association of Neurologists. These many appointments reflect only a fraction of Jim McLeod’s life of service.

McLeod was an outstanding mentor and inspiration for a generation of students, neurologists and scientists. He had a kind and generous manner and was referred to as “Gentlemen Jim”, by colleagues, patients and students alike. As a supervisor, his approach was one of rigour matched with tolerance. He provided a strongly supportive environment in which young researchers could learn and flourish.

We can all learn elements of leadership, but some, like McLeod, were born to lead. He had such a sharp mind he could define the essential issues in complex problems and situations, and was not afraid to take the action he believed would make a difference. He would never ask any of his team to take on responsibilities he was not prepared to shoulder himself.

McLeod was a man of integrity in his life and his work. He never spoke of his many achievements; they did not motivate him but came in abundance, more a by-product of his excellence in academia, his incisive mind, commitment and integrity, and in short, his strength of character. He spent countless hours assisting his colleagues for promotion and other honours.

With all his great achievements, in his own words, it was his marriage to Robyn, and their family, that he regarded as his greatest achievement of all.

Jim McLeod is survived by Robyn, children Anne, Robert, Philip and Rebecca, and 11 grandchildren.

The McLeod Family and Professor John D Pollard AO / Professor Emeritus

Neuroinflammation Group

Brain Mind Research Institute

The University of Sydney

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