Consultant Clinical Scientist – Biochemistry

BSc / MSc / PhD / FRCPath

• Consultant Clinical Scientist to the Birmingham Accident Hospital
• based at the biochemistry laboratory in Selly Oak Hospital which analysed BAH samples
• Although he looked after the entire hospital, he took a special interest in the Major Injuries Unit where his daily physical presence and input was invaluable.
• he believed passionately that it was important for laboratory consultants to understand the pathophysiology of the underlying illnesses of the patients whose biochemistry results they were interpreting and recommending treatment for.
• He recognised that critically injured patients sometimes had multiple organ dysfunction and that what was good treatment for the kidneys might not always be best for the injured brain or lungs.
• His daily attendance on MIU served a dual purpose;
  • To increase his understanding of the clinical conundrums created by injured and burned (and sometimes later septic) patients with multiple organ dysfunction.
  • To educate the doctors and nurses how best to interpret biochemical results and manage with fluids.
• Peter’s PhD investigated metabolic bone diseases and renal function. Renal function was his ‘thing’. At that time, Multiple Organ Dysfunction Syndrome was just being recognised and the idea that every organ might be being affected by an inflammatory response that caused ‘leaky capillaries’ might be the uniting factor.
• The presence of capillary leak detected by proteinuria might possibly predict the onset of Acute Respiratory Distress Syndrome.
• He was involved in the first study which showed that trauma and burns do cause a biphasic (hours, then days) increases in kidney capillary leakiness although it differs in timing between the two groups. Prior proposed causes of microalbuminuria were ruled out and toxic oxygen free radicals were implicated thus linking the leakiness to the systemic inflammatory response.
• This paper published in 1988, was the first to specifically show that the inflammatory response causes microvascular changes in the kidney.  
• The 1988 paper was the first of many research studies that Peter conducted and where he elucidated the mechanisms involved in and the sequalae of the inflammatory response to injury and illness and went on to provide evidence for the most appropriate fluids to mitigate the protein losses facilitated by increased vascular permeability.
• He published more than 100 original papers on the causes, predictive power of surrogate markers of renal dysfunction on future multi organ dysfunction and/or mortality and on the role of mediators in the systemic inflammatory response.
• He also worked with Graeme Dickson and Kaya Alpar. 
• After 1993, Paul Wood and Keith Porter were collaborators.
• As a result of his research, he became well known both nationally and internationally. He was invited to write many review articles and chapters. He also lectured widely to a variety of audiences and organisations.
• He was a key member of the British Consensus Guidelines (many groups were represented including the Association of Clinical Biochemists, Association of Surgeons and the Intensive Care Society) on Intravenous Therapy for Adult Surgical Patients that was updated in 2011.
• Throughout his career, Peter retained his passion for explaining biochemical changes in the light of known pathophysiological disruptions caused by injury or illness. He authored at least three books, possibly more. Of relevance to the injured:

Trauma: A Scientific Basis for Care. E K Alpar, and Gosling P. Taylor and Francis. 1999.

• Another book he wrote was commissioned by the Association of Clinical Biochemists in 2005. Between 2005 and 2011, Peter was running the biochemistry lab with ever decreasing staff and was overwhelmed. The book was completed in 2014.
• However, it was not published until 2016 as the editor opposed the belief that laboratory staff should be a significant presence on the wards especially on Intensive Care Units.

Critical Care and Laboratory Medicine. Gosling P, Sutcliffe A, Dancer F. ACB Venture Publications. 2016.

• Peter was a team player in the widest sense of the word. His approach and work ethic perfectly matched Gissane’s vision of how those looking after patients should work as a team to get the best outcome for the patient.
• From the age of 15 he was a talented clarinet player. His repertoire included classical, light and jazz musical genres. He has played in ensembles around the midlands and he is featured in more than television broadcast