Norman Barrett - Career

Career

He trained at St. Thomas’ Hospital, 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 in 1930. He was awarded the postgraduate degree M Chir in 1931. In 1935, he became a Consultant Surgeon at St. Thomas’, where he remained for the rest of his career.

He travelled to the United States of America on a Rockefeller Travelling Fellowship from 1935-6, working at the Mayo Clinic, and visiting Boston, St. Louis and Michigan. It was during this time that he decided to focus on thoracic surgery, 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 (Boerhaave syndrome), 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, distal to the cricopharyngeal sphincter, which is lined by squamous epithelium". In this paper, Barrett suggested that the finding of an oesophagus lined with columnar epithelium (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 also introduced the term reflux oesophagitis, and described the development of benign oesophageal strictures in patients with this condition.

Allison and Johnstone argued that this columnar epithelium–lined structure was oesophagus and not stomach, and suggested that ulcers 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 surrounding the chronic Barrett's ulcers 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 at the University of London, on the cytology of sputum 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 (1935-1970), Surgeon to King Edward VII Sanatorium in Midhurst, Sussex (1938-1970), and Consulting Thoracic Surgeon to both the Royal Navy and the Ministry of Social Security (1944-1970). He edited Thorax, the journal of thoracic surgery, from its inception in 1946 until 1971.

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